SORE
Seaview Observation & Reporting System
What would you like to report?
*
Please Select
Near Miss
Incident
Accident
Safety Observation
Suggestion
Nice Job
Your Full Name
*
First Name
Last Name
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Email
*
example@example.com
When did this happen?
*
/
Day
/
Month
Year
2 digit day, 2 digit month, 4 digit year
Date
Hour Minutes
AM
PM
AM/PM Option
Where did this happen? (Exact Location)
*
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Describe what happened
*
How serious do you think this is?
*
Please Select
No Biggie
A bit of a worry
Pretty Serious
A big deal, very important
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Incident Details
Are you reporting this incident on behalf of someone else?
*
Please Select
No – I was directly involved in the incident
Yes – I am reporting on behalf of another person
Name of the Person Involved in the Incident
*
First Name
Last Name
Company Name
Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Describe what happened
*
Immediate Corrective Actions Taken
*
List any witnesses or other persons involved
Part of the Body Injured (tick where applicable)
*
Abdomen
Ankle
Arm
Back
Chest
Ear
Elbow
Eye
Foot/Toes
Hand/Fingers
Head
Heart
Hip/Pelvis
Knee
Leg
Neck
Psychological
Shoulder
Trunk
Wrist
Other
Mark the Location(s) of Injury
*
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Do you have any supporting evidence?
Browse Files
Drag and drop files here
Choose a file
Cancel
of
Signature
*
Health & Safety Supervisor to Complete
Please Investigate the Incident and Complete the Report
Please complete this within 48 hours from the date of receipt.
Please Review the Observation/Suggestion
Report Type
Is the incident potentially notifiable to a regulatory body?
*
Please Select
Yes
No
What did you find during your investigation?
*
What caused the incident or near miss?
*
Were there any factors that contributed to the event?
*
Were existing controls adequate?
*
Yes
No
Partially
Not applicable
If no or partially, what control failed or needs improvement?
Could this incident have resulted in a more serious outcome than what actually occurred?
*
Yes
No
If yes, what is the most serious outcome that could reasonably have occurred?
Minor injury / illness
Serious injury / illness
Major property or equipment damage
Environmental harm
Fatality
Other
Are corrective actions required?
*
Yes
No
If yes, what needs to be done to prevent this from happening again?
What lesson should we take from this event?
*
Has the effectiveness of the corrective action been checked?
*
Yes
No
Investigator Name
*
When Investigation Completed
*
/
Day
/
Month
Year
2 digit day, 2 digit month, 4 digit year
Date
Are corrective actions required?
*
Yes
No
Further investigation required
What corrective action implemented?
Reviewer Name
*
When Review Completed
*
/
Day
/
Month
Year
2 digit day, 2 digit month, 4 digit year
Date
Seaview Marina Ltd Doc #: Form 023 SORE Version #: 1.3 Revised on #: 07/09/2026
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