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HowtocompleteaHazardReview

AHazardreviewformmaybecompletedeitheronlineandemailedtosupervisor,orinprintedformand
giventosupervisor

Itisvitalthattheformbecompletedassoonaspossible,withintwentyfourhoursaftertheincident

Theformmustbecompletedby:
Eachemployeeinvolved
Eachwitnesstotheincident
Supervisorondutyatthetimeoftheincident

Eachformmustbesignedwithdateandtimeofincidentandthedateandtimethattheformwasfiled

Indicateiftheformisbeingfilledoutbyanemployeethatwasinvolvedorbyawitness

Includeathoroughexplanationoftheincidentincludingdateandtimeofincidentandlocation.Please
includeanypertinentinformationthatmayhavecontributedtotheincident

Explaintheprocedurestakentocontaintheincident

Giveadetailedlistofanyinjuriesorpossibleinjuriesandanymedicalattentionthatwassought

Provideanyideasforhowtoimprovepoliciesandprocedurestoavoidfutureincidents

Ifmorespaceisneeded,attachadditionalsheetsasneeded

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