Salon Accident Report

Salon Accident Report

Please fill out the details of the accident below.
Salon Number*
Client/Employee Full Name*

First NameLast Name
Employee or Client?*
Employee Role*
Client/Employee Address
Client/Employee Email address
example@example.com
Contact Number*
Date of Accident*

DayMonthYear
Date
Approx Time Range of the accident *

Hour Minutes

AM/PM Option

Until
until
Hour Minutes

AM/PM Option
Nature of the Accident*
Witnessed by:*

First NameLast Name
Location of the accident*
Was Medical Assistance Needed:*

YesNo
What action was taken and by which member of staff
Your Name (staff filling this form)

First NameLast Name
Should be Empty: