Incident, Injury and Near Miss Report Form
v2.2
Purpose. This form captures the facts of any injury, near miss, animal incident, property damage or hazard so it can be investigated and entered in the Incident and Hazard Register.
1.When to use this form
Complete this form on the day for any injury to a person, any injury to a horse caused by handling or equipment, any near miss that could have caused injury, any damage to floats, vehicles or facilities, and any hazard you cannot fix on the spot. Hand it to your supervisor before the end of the shift.
2.Who completes it
The person involved or the first person on the scene completes the form. The supervisor adds their comments and the People, Safety and Compliance team enters it in the register and starts the investigation.
3.What to include
Write what actually happened in plain words, in the order it happened. Name the horse, the gear and the location. Say what first aid or veterinary treatment was given and by whom. Do not guess at causes; the investigation will look at those.
4.Serious incidents
If a person is taken to hospital, a horse is euthanased or there is a fall on the track, the supervisor must phone the People, Safety and Compliance Manager immediately and preserve the scene and the gear until told otherwise. The regulator must be notified of notifiable incidents within the time the law allows.
5.After submission
The People, Safety and Compliance team will acknowledge the report within one working day, record it in the Incident and Hazard Register and assign an investigator. Corrective actions will be tracked to closure and reported at the toolbox talk.