The Critical Incident Report Form is a crucial document used to record and manage significant incidents occurring within organizations operating in Saudi Arabia. It is designed to meet the requirements set forth by Saudi Labor Law (Royal Decree No. M/51), Occupational Safety and Health Regulations, and other relevant local legislation. The form must be completed whenever a significant incident occurs, including accidents, injuries, near-misses, environmental incidents, or security breaches. It captures vital information such as incident details, involved parties, immediate responses, root causes, and corrective actions. This documentation is essential for legal compliance, insurance purposes, trend analysis, and implementing preventive measures. The form serves as an official record that may be required by Saudi authorities during investigations or audits.
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1. Incident Identification: Basic details including incident reference number, date, time, and location
2. Reporter Information: Details of the person reporting the incident, including name, position, contact information
3. Incident Classification: Category of incident (safety, environmental, security, etc.) and severity level assessment
4. Incident Description: Detailed narrative of what occurred, including sequence of events and immediate actions taken
5. Persons Involved: Information about all individuals involved, including injured parties, witnesses, and responders
6. Injury/Damage Details: Specific information about any injuries sustained or damage to property/equipment
7. Immediate Response Actions: Steps taken immediately following the incident, including emergency response measures
8. Root Cause Analysis: Initial assessment of what caused the incident
9. Corrective Actions: Immediate and planned corrective actions to prevent recurrence
10. Management Review: Space for management comments, approval, and sign-off
1. Environmental Impact Assessment: Required when incident involves environmental releases or damage
2. Security Breach Details: Required for incidents involving security violations or unauthorized access
3. Equipment/Machinery Involved: Detailed section for incidents involving mechanical/technical failures
4. Third Party Involvement: Required when contractors or external parties are involved
5. Media/Communications Log: For incidents requiring public communications or media handling
6. Cost Impact Analysis: Assessment of financial implications when significant costs are involved
1. Witness Statement Forms: Standard forms for collecting detailed witness accounts
2. Photographic Evidence: Layout for attaching and describing photographic documentation
3. Incident Scene Diagram: Template for sketching the incident scene and relevant details
4. Risk Assessment Matrix: Standard matrix for assessing incident severity and likelihood
5. Regulatory Reporting Checklist: Checklist of required notifications to authorities based on incident type
6. Investigation Timeline Template: Format for documenting the sequence of investigation activities
7. Medical Report Attachment: Format for attaching relevant medical reports and certificates
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