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Incident Form
Guidlines for Walk Leader
1. When to fill in the form This is a generic incident report for all MFCG walks and requires the reporting of all incidents, whether deemed minor or serious, no matter what the envisaged severity is or if emergency services were or were not required. This includes near misses – an incident may not necessarily involve personal harm or injury. Examples of incidents include a walk where someone has been injured falling off a stile, or tripped on a pavement, damage to property following a gate being left open etc. This form will enable MFCG to gain a better understanding of incidents, monitor trends and provide appropriate guidance and training. It is important that all incidents are recorded and we encourage an open culture of reporting, learning and continual improvement. Please fill in the form as quickly as possible after the incident and return it as soon as possible, and within 7 days maximum. Electronic copies should be sent to Chair and Safety Officer (see website for email address). Hard copy should be posted to Membership Secretary (see website for postal address).
2. How to fill in the form Please provide as much information as possible and use a continuation sheet if necessary. Please provide details of any key witness in case further investigation should be required. You should consider if, due to the nature of the incident, it is best to provide the details of several witnesses.
3. Serious incidents If the incident is of a serious nature, please contact the Club Treasurer (see website) as soon as possible. We are required to report all incidents which may give rise to a claim to Insurers as soon as possible after the event. An incident of a serious nature is defined as posing an immediate danger to life and where outside help is required. This includes: Incidents where 999 has been called to provide urgent medical help ie a heart attack, stroke or severe physical injury. Evacuation of member by emergency services and where urgent medical help is needed. Death of a participant.
Walk Details
Your Name
*
First
Last
Day
*
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Sunday
Date
*
DD slash MM slash YYYY
Time
*
:
Hours
Minutes
AM
PM
AM/PM
Leader
*
First
Last
Person(s) Involved
*
Map Location: Grid/GPS
*
Incident Details
Incident Report
*
Outcome
*