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Appendix 3 - Incident Report Form
Summarise the situation on this form as reported at hours/date.
A new form may be required as the situation becomes clearer and at periodic intervals.
Questions Record Information here
What has happened, e.g. fire,
explosion, theft, malicious damage,
water damage, power failure, denied
access?
Who is involved - any casualties:
• Any injury reports?
• Any staff, visitor or contractor
injuries or fatalities?
• Where are staff now? -
evacuated, or not
• Have incident services (fire,
police, ambulance)/ local
authority been called?
When did it occur?
Where is the problem?
Why did it happen? If known at this
stage.
Who is in charge of the situation?
Who knows about the situation so
far? Who else needs to know?
When was the Principal contacted
and by whom?
Please note any lessons learned, and
any suggested improvements to the
Business Continuity Plan.
Noted By