The Glasgow School of Art Procedure for the Reporting of Accidents, Incidents and Near Miss Events

 
 
 

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6 of 8 
PART A 
Details of Injured Person, please
detail as much as possible 
insuring it is accurate at the 
time of the accident/ near
miss
Send reports to: 
-
White
Copy: Health and Safety Team 
-
Yellow 
Copy: HR/Registry 
(Staff Incidents to HR, Student Incidents to Registry) 
-Pink
Copy: Keep on file within department.
School or professional support 
area, and the department 
PART B 
Date:
DD/MM/YY
Time:
If not exact estimate to the 
nearest half hour. 
Where: 
Detail 
building, floor, and department. If 
possible note where this close 
to/near. 
PART C 
Describe what happened in as 
much detail as possible, and if 
required use 
a separate sheet. 
- The lead up the event. 
- How the event occurred 
- What activity was being 
carried out? 
- If there was any machinery
or dangerous equipment/ 
substances involved. 
- If a student was involved,
note what studio space/class 
this was being carried out in. 
PART D 
Specify exactly where on the body 
the injury was sustained for 
example: 
- Left thumb 
- Left leg above the knee
- Right arm below the elbow etc
.
 
Completed by Health 
and Safety Team 
PART G 
- 
What happened after the accident 
occurred? 
- What has been put in place to 
prevent this happening again? 
- Were there any repairs carried out? 
- Had the affected person been 
spoken to? 
PART F 
Note the name of the Head of 
department/ Responsible person/First 
Aider or Technician at the workplace 
where it occurred
PART E 
- Tick box if first aid was 
administered. 
- Detail full name of trained 
first aider.
- Give full details of anyone 
who was present when the 
event occurred.
- Note who is filling the form 
out and their full name.