Accident Report Form

This form is to be completed by MS Society employees and volunteers where an accident results in a person being injured, however minor the injury.


If an employee, please enter their department and building

If a volunteer, please detail the group

If you did not have the accident but are filling the report, place your details below.

(building, department, room within the building, vehicle etc.)

Please provide full name, full postal address and contact numbers of any witnesses available.

Data provided in this form will be used to review the accident and will be stored in line with the MS Society data retention schedule. The information will be shared with the Health and Safety Executive when required by law.

Please tick the box below and input your email address to receive a copy of the completed form. This should be shared with the person involved in the accident and should then be deleted.

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