AFC Incident Report
Use this form to report any health & safety incidents or near misses related to training with AFC.
Event Type *
Date *
of Incident or Hazard ID
MM
/
DD
/
YYYY
Location *
of Incident or Hazard ID
Your answer
Event/Training *
Your answer
Reported by *
Your name
Your answer
Diver *
Diver's Name (put your name if reporting a hazard or suggestion for improvement)
Your answer
Details of Incident or Hazard *
What happened? What did you see?
Your answer
Contributing Factors / Root Causes
Why did it happen? Why is it a hazard?
Your answer
Description of Action Taken *
What did you do in response to incident or hazard ID?
Your answer
Further Actions *
What steps have you and/or diver taken to ensure this doesn't happen again? What suggestions for improvement do you have?
Your answer
Actions Taken *
Required
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