Dyson Farming

Accident Form

Accident Report Details

Complete the form below to notify Head Office of any accidents.

  • 1. About the person who had the accident

  • 2. About the person filling in the accident report

  • If you did not have the accident, complete your name, address, postcode and occupation.
  • 3. About the accident

  • DD slash MM slash YYYY
  • Drop files here or
    Accepted file types: jpg, gif, png, pdf, Max. file size: 50 MB, Max. files: 5.
    • Please sign and date:
    • DD slash MM slash YYYY
    • 4. For the employee only

    • DD slash MM slash YYYY
    • 5. For the employer only

    • Complete this box if the incident is reportable under the Reporting of Injuries, Diseases and Dangerous Occurrences Regulations (RIDDOR). To report go to www.hse.gov.uk/riddor/
    • DD slash MM slash YYYY