The Incident Notification Form is a crucial document required under Singapore's workplace safety framework. It must be completed when workplace accidents, near-misses, or dangerous occurrences take place, as mandated by the Workplace Safety and Health Act. The form captures essential information including incident details, affected parties, witness accounts, and immediate actions taken. It serves multiple purposes: regulatory compliance, incident investigation, risk management, and maintaining safety records. Organizations must submit this form within specified timeframes to the Ministry of Manpower, particularly for reportable incidents.
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1. Incident Details: Date, time, location, and nature of incident including sequence of events
2. Affected Parties: Information about individuals involved or affected including their role and contact details
3. Incident Description: Detailed narrative account of what occurred, including any contributing factors
4. Immediate Actions Taken: Response measures implemented and emergency actions carried out
5. Witness Information: Details of any witnesses present, including their contact information
1. Medical Report Section: Details of injuries sustained, treatment provided, and medical professionals involved
2. Property Damage Assessment: Comprehensive evaluation of damage to property, equipment, or facilities
3. Environmental Impact Assessment: Analysis of any environmental consequences and containment measures
4. Root Cause Analysis: Investigation findings on the underlying causes of the incident
1. Schedule A - Photographs: Visual documentation of incident scene, damages, and relevant evidence
2. Schedule B - Witness Statements: Detailed written accounts from all witnesses present during the incident
3. Schedule C - Medical Certificates: Copies of relevant medical documentation and certificates
4. Schedule D - Investigation Reports: Complete investigation findings, analysis, and recommendations for prevention
5. Schedule E - Regulatory Compliance Checklist: Checklist confirming compliance with relevant Singapore regulations and reporting requirements
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