Accident Reporting Form

Please use this form to report all accidents, whether reportable to HQ or not.

Please submit this form with as much detail as possible to describe the nature of the injury and what led to it as well as any treatment given and by whom it was administered. We may also need to record the names of any witnesses.
Name of leader reporting the accident
Enter your Dringhouses Scouts email address

About the Casualty

Please complete the following fields, a separate form will be required for each casualty
Please enter the name of the casualty
Please enter the date of birth of the casualty
Please enter the address of the casualty
Please indicate if the casualty is a child or an adult

About the Incident

Please enter full details of what happened in the fields below
When did the incident occur?
Please enter the location that the accident happened
Please describe the type of injury and where is on the body as specifically as possible
Please list in as much detail as possible the treatment that was given and by whom it was administered
Please let us know if social distancing rules were broken.
Please list the name and email address/ phone number of anyone who witnessed the incident
If a bump on the head form was not issued to the parent/ carer directly please ensure that they are contacted immediately to confirm the form was received
Note you don't necessarily need to inform everyone on this list, it is useful to keep a record of who was contacted
Please see the Group's data privacy notice