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Health and Safety

Executive

Health and Safety at Work etc Act 1974

The Reporting of Injuries, Diseases and Dangerous Occurrences Regulations 2013

Report of an injury offshore

About you and your organisation

(eg building name)

(eg street)

(eg district)

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Health and Safety

Executive

Report of an injury offshore

About where the incident happened

The position of the installation, well vessel or pipeline

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Health and Safety

Executive

Report of an injury offshore

About the incident

(24 hr clock)

What type of work was being carried out (generally the main business activity of the site)?

About the kind of accident

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HSE Logo

Health and Safety

Executive

Report of an injury offshore

About the injured person

(eg building name)

(eg street)

(eg district)

*Gender

Injured person's employment status

*Was the injured person:

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Health and Safety

Executive

Report of an injury offshore

* Please refer to the help for guidance on severity of injury.

About the severity of the person's injuries

*Please help us determine the severity of the injury - was the injury fatal ?

If no, the injury prevented the worker from carrying out their routine work for more than 7 days or

The injury was to a member of the public taken directly to hospital/injured on hospital premises

About the person's injuries

Please check your email address below. Ensure that you change if incorrect as this is the email address that your acknowledgement and a copy of the form will be sent to.

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