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National Office

02 6938 2121

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Incident Report Form

This form is to be used to report all injuries, illnesses, or near misses, whether an injury occurred or not, and to document the investigation.
Please complete within 24 hours of the incident.

Required fields in the form are marked with an *


SECTION A: TO BE COMPLETED BY PERSON INVOLVED

DETAILS OF PERSON INVOLVED


DETAILS OF THE INCIDENT


PART OF BODY AFFECTED


DETAILS OF THE INCIDENT/INJURY/NEAR MISS


SECTION B: TO BE COMPLETED BY THE SUPERVISOR & THE PERSON INVOLVED WITHIN 48 HOURS

This is an extremely important section as the aim of the incident investigation is to identify preventative action that will avoid recurrence.

DETAILS OF THE CAUSE OF THE INCIDENT/INJURY/NEAR MISS


PREVENTION OF INCIDENT RECURRENCE


DETAILS OF PROFESSIONAL SERVICES INVOLVED


LOCAL ADMINISTRATORS DETAILS


Thank you for completing the online Incident Report Form.
By submitting this form you accept responsibility to the actual events and outcomes possibly attained from this incident as a true statement.

July 2022 CTSN

On the cover: Jack Stockdale, ACTA 2022 Hall of Fame Inductee with Aislin Jones

Inside this month's edition

ACTA Report
2022 ACTA Skeet Nationals
Skeet Hall of Fame Dinner
Gold, Silver, Bronze – Junior ISSF World Cup
Vale – Pam Cook
Arnhem Gun Club – Shooters with Hooters
Vision and Shooting
VCTA Five Stand Sporting Championships
Australia Dominate in Granada
Psychological Skills for Shooting
Maryborough Invades Ararat
Competition Results: TAS, NSW, WA, QLD, SA, NT, VIC
What’s Happening in the VCTA
NSWCTA 2021 State Skeet Championships
Great June Day at Bega
Perfect Conditions in Wangaratta
Maryborough & District Gun Club News
Break Badges
New Members
Shoot Calendar


Download PDF          View FLIPBOOK
This month's CTSN

Call the National Office

02 6938 2121