Company Details


    Incident Details

    Was time lost through the injury?

    YESNO

    Was the incident reportable under RIDDOR?

    YESNO


    Type of injury?


    Area(s) affected

    Was the injured party wearing gloves?*

    YESNOUnknown

    If yes, were the gloves in good condition?*(other than damage caused as a result of the incident)

    YESNOUnknown

    Were the gloves the correct size for the injured party?*

    YESNOUnknown


    Incident summary

    If hand protection was worn, what was the product reference and/or specification of the glove used? *

    Alternatively, submit a photograph here: