Fillable COVID-19 Incident report form (NASUWT)

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COVID-19 Incident report form (NASUWT)

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The COVID-19 Incident report form (NASUWT) form is 1 page long and contains:

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Country of origin: UK
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COVID-19
Incident report form
Date of incident: _________________________________
Time of incident: ________________________________
Location of incident: ______________________________
Brief description of the incident and who was involved.
I am logging this incident as I am aware that under the provisions of Health and Safety
legislation I have a responsibility to safeguard my own health and safety and to report
any concerns that I have to my employer.
I am also sending a copy of this incident report to my Union, the NASUWT.
Signed* : ________________________________________________________
(*please print name as well as signature)
Date submitted to the Principal : ______________________________
Name of school/college : ________________________________________
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COVID-19 Incident report form (NASUWT)

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Completed 20 January 2021

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