If you discover a serious risk of immediate harm please contact your line manager or Health & Safety straight away

When completing this form please try to include as much additional information as you can.  Details of surrounding area, contributing factors to the near miss and the type of activity being undertaken will all help in ensuring the best possible action is taken.

 

Name: 

Email address: 

Location of incident*: 

Details of near miss*: 

* required

 

THE SMALL PRINT - BORING, YES . . . BUT REALLY IMPORTANT! 

  I have read and understood that if I have submitted personal details in any format: name or email address, that I consent to them being used for the purposes of following up with the near miss documented only and helping UCSU comply with their legal obligations.

  I am aware that when completing this form, my name and email will be displayed on the email sent if I am logged into the website.