Our Address

Lancashire Hill Ltd,

55 Layton Road,

Blackpool,

Lancashire. FY3 8EB.

07773 777309 nicola@lancashirehill.co.uk

REPORTING AN ACCIDENT OR INCIDENT.

Letting us know about an accident, an incident or a near miss, is important so that we can investigate and address the possible causes to hopefully avoid it happening in the future.

It gives us an opportunity to put matters right for you and improve your environment.

Please can you complete the online form below with as much detail as you can recall? If there were any witnesses to the incident, please also give their details so we can speak to them too.

We’re sorry to hear about this but we will do our best to put it right.

ONLINE INCIDENT / ACCIDENT FORM

Name

First Name

Last Name

Contact Number

Email Address

Property or premises

What is the address of the property? Is there a specific room or area? Inside/ outside? Where did it happen?

What was the date and time of the incident?

Please give the date and time of the incident, or the from and to times?

Please describe what happened?

Please describe what happened before, during and after the incident? Be as detailed as possible.

Were there any other contributing factors to the incident?

Thinking about what happened, were there any other elements that might have contributed to the incident?

Please describe any injury sustained?

If injury was caused, please describe this, together with any medical treatment you have received and any prognosis by professionals? Please advise whether you have any photographs of the injury and any documentation from medical treatment?

Please detail any witnesses and or footage?

Witnesses can be people who were present at the time, and also someone you told immediately afterwards even if they weren't there at the time. Also, do you believe the incident could have been captured on video or CCTV?

Suggestion of what you believe we could do to put things right.

Please tell us what you feel would prevent this occurring in the future and any other actions you feel are necessary?

Any other comments or information you would like to share?

Signature - please read the text below

When you write your name and date of birth in this box, we assume you are happy for us to investigate this matter and to speak to other persons concerned. We may also bring the matter to the attention of other house mates for their safety or information. If you do not wish this to be fully investiagted, please write "NFA" in the box instead.

HOW WE WILL HANDLE THIS.

No matter how you communicate with us, we’ll listen and endeavour to act on your needs. Once you've contacted us, we'll do our best to resolve the matter immediately. We will keep you update on actions taken.

Thank you for your time in sharing this information.

Incident Report

Our Address

REPORTING AN ACCIDENT OR INCIDENT.

ONLINE INCIDENT / ACCIDENT FORM

HOW WE WILL HANDLE THIS.