Cleaning Services Accident Report Slip Template
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Cleaning Services Accident Report Slip

This Accident Report Slip is designed for incidents occurring within [Your Company Name]. It serves as a formal document to report accidents, injuries, or incidents that happen during work hours.

Accident Details

Field

Information

Date:

Time:

Location of Incident:

Nature of Incident:

Injured Person(s):

Witness(es):

Type of Injury:

  • Cut

  • Bruise

  • Sprain

  • Fracture

  • Other (pls. specify):

Severity:

  • Minor

  • Moderate

  • Severe

Medical Treatment Provided:

  • Yes

  • No

Additional Information

Field

Information

Reported by:

Contact Details:

Date:

Time:

Note: Please retain a copy of this slip for your records.

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