The Incident Notification Form is a crucial document required under Qatar's workplace safety framework, primarily governed by Labor Law No. 14 of 2004 and subsequent ministerial decisions. This form must be completed immediately following any workplace incident, accident, or near-miss situation. It serves multiple purposes: ensuring proper documentation of events, facilitating communication with relevant authorities, supporting insurance claims, and maintaining compliance with legal requirements. The document is designed to capture comprehensive information while being accessible to all levels of employees who might need to complete it in urgent situations. The form's structure allows for detailed recording of various incident types, from minor accidents to serious workplace events, and includes provisions for immediate response actions and authority notifications as required by Qatari law.
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1. Incident Reference Details: Basic information including date, time, location, and reference number of the incident
2. Reporter Information: Details of the person reporting the incident, including name, position, contact information, and relationship to the incident
3. Incident Description: Detailed account of what happened, including sequence of events and immediate actions taken
4. Affected Parties: Information about all persons involved in or affected by the incident, including employees, contractors, or members of the public
5. Injury/Damage Assessment: Description of any injuries sustained or property damage incurred
6. Witness Information: Details of any witnesses to the incident, including contact information
7. Initial Response Actions: Description of immediate actions taken to manage the situation and prevent further harm
8. Authority Notification: Details of notifications made to relevant authorities (police, ambulance, civil defense, etc.)
9. Declaration: Confirmation of accuracy of information provided and signature section
1. Environmental Impact: Required when incident involves environmental aspects such as spills or emissions
2. Equipment/Machinery Involved: Needed when incident involves machinery, tools, or equipment failure or malfunction
3. Security Incident Details: Required for incidents involving security breaches or criminal activity
4. Medical Response Details: To be included when medical treatment was provided or required
5. Risk Assessment: Optional section for immediate assessment of ongoing risks and preventive measures
6. Media/External Communications: Required if incident has public visibility or media involvement
1. Incident Scene Photographs: Appendix for attaching photographs or diagrams of the incident scene
2. Witness Statements: Additional forms for detailed witness accounts
3. Medical Reports: Attachments for any immediate medical reports or assessments
4. Property Damage Report: Detailed listing and documentation of property damage
5. Initial Investigation Findings: Preliminary findings from any immediate investigation conducted
6. Relevant Certificates/Licenses: Copies of relevant certifications or licenses related to the incident (e.g., machinery operation licenses, safety certificates)
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