Health and Safety Data Reporting Form Health, Safety and Environment Company Name What is your main area of operations/services?Flat Glass manufacturerGlass ProcessorIG ManufacturerSpecial ApplicationCurved Glass ManufacturerToughened Glass ManufacturerLaminated Glass ManufacturerDecorative Glass ManufacturerWindow and Door fabricationConservatory fabricationSystems HousesGlass InstallersWindows, Doors and Conservatory installerGlass ComponentsMultiple sectorsConsultancyRecycler/waste managementFire ResistantSurface ApplicationsDistributionEmergency Glazing(please select the most relevant from the list below)Number of employeesPlease enter a number from 1 to 500.Total number of Accidents (for the year to-date)Please enter a number from 0 to 12.If applicable; detail your Accident frequency ratesTotal Number of fatal accidents (for the year to-date)Please enter a number from 0 to 12.Total Number of RIDDOR reportable accidents (for the year to-date)Please enter a number from 0 to 12.Detail number of “Over Seven day incapacitation of worker” (for the year to-date)Detail number of “Accidents to members of public resulting in them being taken straight to hospital” (for the year to-date)Please enter a number from 0 to 12.Detail number of “Specified injuries” (for the year to-date)Please enter a number from 0 to 12.Detail number of “Dangerous occurrences” (for the year to-date)Please enter a number from 0 to 12.Select from the list below for your businesses top five risk areas Contact with machinery Human contact with external vehicles/Vehicle collision Fall from heightSlips and trips Cuts Contact with harmful substance Contact with a biological substance Burns Fire Falling item Violence Entrapment Lifting operations workplace transport (FLT’s. VNA’s etc) Violence Trespassing Culture Behaviours Human Factors Human Error Mental health and stress Employee health and welfare Other (please detail) Detail below positive work you have done or that exists in your organisation this periodeg increase employee engagement, invested in equipment, addressed some goal conflicts, visible leadership, learning opportunities, etc.
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