Incident Hazard Report

This form is used by trainers and staff to report any hazards or incidents that have occurred in The Barber Academy or The Hair Academy. Please raise any urgent issues immediately with management, complete this form and lodge as soon as the hazard/incident occurred. The trainer will report back to management regarding any further action.

Name of person reporting

Date of report:

Time of report:

Department/Location

Incident / Hazard Details

Type of report:

Incident

Hazard

Near Miss

Date of Incident/Hazard

Time of Incident/Hazard

Location of Incident/Hazard

Description of Incident/Hazard

Was anyone injured?

Yes

No

If yes, name(s) of injured person(s):

Nature of injury:

Was medical treatment required

Yes

No

If yes, describe treatment:

What was done immediately after the incident or upon identifying the hazard?

Risk Assessment

Likelihood of Re-occurrence:

Unlikely

Possible

Certain

Severity of Potential Harm:

Minor

Major

Critical

Suggested Corrective Actions /Recommendations: