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Submitting Incident Alerts

Thank you for your interest in sharing information about a "near miss" or accident that has occurred within your company. By sharing this information with others you will help to reduce the potential for similar accidents to occur in other companies. However, before you complete the form please can you consider the following three points
  1. Have you been authorised by your company to submit alerts
  2. Is there another individual within your organisation with whom you should consult with before sending an incident alert
  3. Incident alerts will not be attributed to your company but your company may be identifiable from text or photographs
Following receipt of your request to be registered to submit alerts you will be contacted by a representative of

About You
First Name
Job Title
Company Name
City / town
Post Code
Contact Telephone No.
Mobile No.
Email Address
Brief Description of your main job function