Event Injured Person’s Role: Staff INCIDENT CONSEQUENCE (refer to consequence guide below) Insignificant Minor Moderate Major Extreme CONSEQUENCE CATEGORIES Insignificant Minor Moderate Extreme Medical treatment Medical treatment Fatality or serious Health & Safety No injury or illness Minor 1st Aid (< 2 months) (>2 months) injury / disability Minimal damage. Short-term damage. Severe long-term Medium-term Extreme, long-term Type Low loss or Noticeable loss or damage. loss damage. Significant damage. Complete Environmental degradation. degradation. or degradation. loss or degradation. & permanent loss. Minimal overall in time Major rehab Risk Rehab required Not repairable impact (no rehab) required COMMENTS SIGN-OFF (by the person completing this form) Name: Mobile: Signature: Date:
Injured Person’s Role: Event Staff INCIDENT CONSEQUENCE (refer to consequence guide below) Insignificant Minor Moderate Major Extreme CONSEQUENCE CATEGORIES Insignificant Minor Moderate Extreme Risk Type Health & Safety No injury or illness Minor 1st Aid Medical treatment (< 2 months) Medical treatment (>2 months) Fatality or serious injury / disability Environmental Minimal damage. Low loss or degradation. Minimal overall impact Short-term damage. Noticeable loss or degradation. in time (no rehab) Medium-term damage. Significant loss or degradation. Rehab required Severe long-term damage. loss or degradation. Major rehab required Extreme, long-term damage. Complete & permanent loss. Not repairable COMMENTS SIGN-OFF (by the person completing this form) Name: Mobile: Signature: Date:
TR-Incident-Report-Form-Forest-Permit-for-website.docx