Accident Reporting | GCC Facilities Management Ltd

Health & Safety Reporting Form

Please complete this form to make an Accident/Near Miss/Damage to Property Report. You can also make a report by emailing: HealthandSafety@gccfm.com

Name of Injured Person/Description of Damage to Property(Required)

Position/Role within the company

Injured Person's Email Address

Injured Person's Phone Number

Name of Person making this report(Required)

Position/Role within the company

Reporting Person's Email Address(Required)

Reporting Person's Phone Number(Required)

When did the accident happen? (Date)(Required)

When did the accident happen? (Time)(Required)

What damage occurred and what injuries were sustained (if any)?(Required)

Where did the accident happen? (State room or location)(Required)

How did the accident/incident happen? (Give cause if you can)(Required)

What activities/tasks were being carried out at the time of the accident?(Required)

Existing Customers

New Business

Registered Office

8-10 High Street
Sutton
Surrey
SM1 1HN

Working Days

Monday – Friday

Office hours

9:00am - 5:30pm