Incident Reporting

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In: MVB-Articles

Published: 12 August 2020

Last Updated: 12 August 2020

Created: 12 August 2020

INCIDENT REPORT FORM

Incident Report Form

MVB Inc Incident Report Form

To be completed by event coordinator or leader(s) as soon as practical after the incident. This report should be kept by the club secretary as a formal club record. In the event of any serious injury (an injury requiring medical treatment) copies of the incident report must be forwarded to the Insurance Convener for the State of the Member Club.

Report prepared by"(*)

Please type your full name.

Email of report writer(*)

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Phone of report writer(*)

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Mobile phone number preferred

Address

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Please enter your full address and postcode

Date the incident occurred(*)

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Enter the time the incident occurred(*)

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Select the type of event(*)

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Please enter the location where the incident occurred(*)

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Injury, missing person, damage to property, theft, fire etc(*)

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(*)

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Please describe the incident

Please describe actions taken(*)

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Were authorities or other agencies notified at the time?

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Who contacted external authority?

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How were external authorities contacted?

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Did an external authority take a role in managing the incident?

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Have the insurers been notified (if appropriate)?

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What was the final outcome? When was it resolved?(*)

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Can this incident be prevented and if so how?

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Upload documents eg statements, maps, photos

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This form is a component of the Murray Valley Bushwalkers Inc risk management policies.

Click the submit button to post this report to the MVB secretary