INCIDENT REPORT Methodist Church of New Zealand Caring for Our People Abc Church Manaakitia Tātou Tāngata ā Street Address, Town Name: INCIDENT REPORT I had a: Near Miss [nothing happened but it might/sticking plaster or less to fix] Name: Minor Incident [more than a sticking plaster/people had to help] I had a: Major Incident [major first aid/doctor follow up/ambulance maybe] Near Miss [nothing happened but it might/sticking plaster or less to fix] Date: Time: Minor Incident [more than a sticking plaster/people had to help] Where: (be specific so others can identify the spot) Major Incident [major first aid/doctor follow up/ambulance maybe] What happened: Date: Time: Any action taken to stop this happening again? (who did what, and when) Where: (be specific so others can identify the spot) Fix-it action still to be taken Suggestions to fix it? Thank you for also helping others and taking the time to fill in this report! What happened: Please give this to [the presbyter]. Use the other side of the page if necessary Any action taken to stop this happening again? (who did what, and when) Fix-it action to be taken Suggestions to fix it? Thank you for also helping others and taking the time to fill in this report! Please give this to [the presbyter]. Use the other side of the page if necessary Methodist Church of New Zealand Caring for Our People Abc Church Manaakitia Tātou Tāngata ā Street Address, Town
Methodist Church of New Zealand Caring for Our People Abc Church Manaakitia ā Tātou Tāngata Street Address, Town INCIDENT REPORT Name: I had a: Near Miss [nothing happened but it might/sticking plaster or less to fix] Minor Incident [more than a sticking plaster/people had to help] Major Incident [major first aid/doctor follow up/ambulance maybe] Date: Time: Where: (be specific so others can identify the spot) What happened: Any action taken to stop this happening again? (who did what, and when) Fix-it action to be taken Suggestions to fix it? Thank you for also helping others and taking the time to fill in this report! Please give this to [the presbyter]. Use the other side of the page if necessary Methodist Church of New Zealand Caring for Our People Abc Church Manaakitia ā Tātou Tāngata Street Address, Town INCIDENT REPORT Name: I had a: Near Miss [nothing happened but it might/sticking plaster or less to fix] Minor Incident [more than a sticking plaster/people had to help] Major Incident [major first aid/doctor follow up/ambulance maybe] Date: Time: Where: (be specific so others can identify the spot) What happened: Any action taken to stop this happening again? (who did what, and when) Fix-it action still to be taken Suggestions to fix it? Thank you for also helping others and taking the time to fill in this report! Please give this to [the presbyter]. Use the other side of the page if necessary
incident%20report%20form.docx