Near Miss/Minor Incident Report
The aim of this form is to to allow leaders to report incidents that have could have caused an injury or death if there was change in how events unfolded. This could be a hazard that was not adequately controlled or leaders' actions that came close to causing injury or death. The aim of near miss reporting is to provide opportunities for learning so that similar events do not occur again therefore any submissions from this report are anonymous and will only be seen by trustees and the group leadership roles. 
In the event accident or injury does occur, and medical treatment is required, then this must be reported to scouts HQ and the group leadership team should be liaised with. In this case please do not report them via this form, instead speak to Allison or Charlie who will deal with it under scout reporting guidance. Minor injuries that require first aid, but no medical attention, can be reported with this form. 
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What was the date of the incident? *
MM
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DD
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YYYY
Which section(s) were involved in the incident? *
Required
Please describe the activity that was taking place at the time of the incident.  *
Please, in as much detail as possible describe the incident that took place. Give details of leader locations, numbers of young people, and the nature of the hazard.  *
Optional: Please name leaders present at the time of the incident. (All responses are completely anonymous.)
Was there a risk assessment at the time and had it been communicated to leaders? *
Please give details of how the hazard had already been controlled in the risk assessment  and the acceptable levels of risk identified in the risk assessment. Please also note if the hazard hadn't been identified beforehand. *
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This form was created inside of Southampton City Scout District.