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RIDDOR Incident Report Form

Safety & Compliance · Intermediate

Complete immediately after any RIDDOR-reportable incident. Report to HSE online within the required timeframe. Fatal and specified injuries must be reported without delay by phone (0345 300 9923).

30 items 20–30 min 46 downloads Download PDF Use in App

An internal documentation form for employers recording the details of incidents that are reportable under the Reporting of Injuries, Diseases and Dangerous Occurrences Regulations 2013 (RIDDOR). Captures incident details, injured person information, nature and severity of injury, circumstances and root cause, immediate actions taken, and notification status with HSE.

Employers must report specified workplace incidents to HSE — deaths, specified injuries, over-7-day incapacitation injuries, occupational diseases, and dangerous occurrences. This form captures all the information needed for the HSE online report and creates the internal record that must be retained for at least 3 years.

This checklist template is provided as a general-purpose resource and is not tailored to the regulatory requirements of any specific country, region, or jurisdiction. It is the responsibility of each organisation to review and adapt this template to ensure compliance with all applicable local laws and regulations. Miratag does not accept liability for any inaccuracies or omissions, or for any actions taken based on this template.

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