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Critical Incident Report Form

Critical Incident Report Form Template for Germany

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Key Requirements PROMPT example:

Critical Incident Report Form

"I need a Critical Incident Report Form for our chemical manufacturing facility in Hamburg, compliant with German regulations, with special emphasis on hazardous materials handling and environmental impact reporting sections."

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Document background
The Critical Incident Report Form is a crucial document required under German workplace safety regulations, specifically designed to comply with the Arbeitsschutzgesetz and DGUV requirements. It is implemented when significant workplace incidents, accidents, near-misses, or safety concerns occur that require formal documentation and investigation. The form ensures systematic collection of incident-related information, facilitates proper reporting to relevant authorities and insurance providers, and supports the organization's safety management system. It includes sections for incident details, affected parties, immediate actions taken, and follow-up measures, while maintaining compliance with GDPR requirements for handling personal information.
Suggested Sections

1. Report Identification: Unique report ID, date and time of report creation, and classification of report urgency

2. Incident Details: Date, time, location, and type of incident

3. Persons Involved: Details of affected individuals, witnesses, and reporting person (in compliance with GDPR)

4. Incident Description: Detailed narrative of the incident, including sequence of events and immediate impact

5. Immediate Actions Taken: Emergency responses and immediate measures implemented to contain the situation

6. Impact Assessment: Evaluation of damage or harm to persons, property, or operations

7. Initial Root Cause Analysis: Preliminary assessment of factors contributing to the incident

8. Notification Record: List of authorities, stakeholders, and parties notified of the incident

9. Report Authorization: Signatures and details of persons completing and reviewing the report

Optional Sections

1. Environmental Impact: Used when incident involves environmental hazards or contamination

2. Equipment/Asset Damage: Required when incident involves damage to machinery, tools, or facilities

3. Customer/Client Impact: Include when incident affects external stakeholders or service delivery

4. Media/Public Relations: Used for incidents with potential public visibility or media interest

5. Insurance Notification: Include when incident requires insurance claim submission

6. Union Representative Statement: Required when incident involves union members or workplace safety concerns

Suggested Schedules

1. Photographic Evidence: Photos or visual documentation of the incident scene and damages

2. Witness Statements: Detailed accounts from witnesses (using standardized statement forms)

3. Medical Reports: Copies of relevant medical documentation if injuries occurred

4. Risk Assessment: Pre-existing risk assessment relevant to the incident area/activity

5. Equipment Inspection Records: Recent inspection records if equipment was involved

6. Incident Scene Diagram: Sketches or diagrams showing the incident location and relevant details

Authors

Alex Denne

Head of Growth (Open Source Law) @ ¶¶Òõ¶ÌÊÓƵ | 3 x UCL-Certified in Contract Law & Drafting | 4+ Years Managing 1M+ Legal Documents | Serial Founder & Legal AI Author

alex.den.21@genieai.co
Relevant legal definitions






























Clauses




















Relevant Industries

Manufacturing

Healthcare

Construction

Transportation

Energy

Chemical Industry

Food Processing

Logistics

Mining

Education

Retail

Hospitality

Pharmaceutical

Information Technology

Public Services

Relevant Teams

Health & Safety

Human Resources

Operations

Quality Assurance

Risk Management

Compliance

Facility Management

Security

Environmental Health

Production

Maintenance

Project Management

Legal

Emergency Response

Occupational Medicine

Relevant Roles

Health and Safety Manager

Facility Manager

Department Supervisor

HR Director

Quality Assurance Manager

Operations Manager

Risk Management Officer

Compliance Officer

Plant Manager

Security Manager

Environmental Health Officer

Production Supervisor

Maintenance Manager

Project Manager

Site Coordinator

Industries







Teams

Employer, Employee, Start Date, Job Title, Department, Location, Probationary Period, Notice Period, Salary, Overtime, Vacation Pay, Statutory Holidays, Benefits, Bonus, Expenses, Working Hours, Rest Breaks,  Leaves of Absence, Confidentiality, Intellectual Property, Non-Solicitation, Non-Competition, Code of Conduct, Termination,  Severance Pay, Governing Law, Entire Agreemen

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