Minor Injury & Incident Report
Use this form to report minor injuries sustained while working or requiring something from the First-Aid Box. Or to report any incident that impacts safety in Makespace.
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Email *
What  is your name? *
What was injured or what was the nature of the incident? *
Please be detailed about the incident and provide information about what was happening before, during and after.
How did the injury or  Incident happen? *
What did you use from the First-Aid kit? *
Required
What can Makespace do to prevent similar injuries or incidents?
Thank you for reporting this incident.
A copy of your responses will be emailed to the address you provided.
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