Incident reporting

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1. Incident reporting
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Please ensure that any immediate dangers are addressed immediately by the relevant authority i.e. event organiser, QML duty manager, security or police. Please do not include specific patient details in this form. Use the relevant QML documentation to record patients identifiable data.
 

1. When did this incident occur?

   DD/MM/YYYY 
 
 

2. Name of person completing this form

 

3. Job role of person completing this report

 

4. Where did this incident occur ?

 

5. Is this an incident (where harm has occurred) or a near miss (where there was the potential for harm to occur)