Nursery Accident Form Template UK

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The Nursery Accident Form Template UK is provided in multiple formats, including PDF, Word, and Google Docs, featuring customizable and printable versions.

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Sample

Nursery Accident Form Template UK

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PDF – 1 PDF – 2

Nursery Accident Form Template UK

1. Child Information


2. Parent/Guardian Information


3. Accident Details


4. Location of Accident

5. Immediate Action Taken

6. Nature of Injury

7. Follow-up Actions Required

8. Witness Information


9. Parent/Guardian Acknowledgment

10. Signatures and Agreement



PDF

WORD

Examples

Nursery Accident Form Template UK (1)
Date of Incident:
[Date]
Time of Incident:
[Time]
Child’s Name:
[Child’s Full Name]
Child’s Date of Birth:
[Child’s Date of Birth]
Address:
[Child’s Address]
Details of Accident:
[Provide a detailed description of the accident, including what happened and how it occurred. Explain any activities involved and any other children present.]
Injuries Sustained:
[List any injuries sustained, including the location of the injuries, severity, and whether first aid was administered.]
First Aid Administered:
[Describe any first aid measures taken, including name of the person who administered the first aid and details of the treatment given.]
Notification:
Was the parent/guardian notified? [Yes/No]
If yes, provide details: [Name of the person notified and time of notification.]
Name of Staff Completing Form:
[Staff Member’s Name]
Signature of Staff:
[Signature]
Comments:
[Any additional comments or observations related to the incident.]
Signed by Parent/Guardian:
[Signature of Parent/Guardian]
[Date]
Nursery Accident Form Template UK (2)
Date of Incident:
[Date]
Time of Incident:
[Time]
Child’s Name:
[Child’s Full Name]
Child’s Date of Birth:
[Child’s Date of Birth]
Address:
[Child’s Address]
Details of Accident:
[A comprehensive description of the incident, mentioning any specific circumstances that led to the accident, including toys, equipment, or activities involved.]
Injuries Sustained:
[Detail the nature and extent of injuries, including whether medical treatment was required and where the injuries occurred on the child’s body.]
First Aid Administered:
[Outline first aid procedures followed, along with the name of the staff member who provided care and the specifics of the treatment given.]
Notification:
Was the parent/guardian notified? [Yes/No]
If yes, detail who was contacted and how, providing time and method of communication.
Name of Staff Completing Form:
[Staff Member’s Name]
Signature of Staff:
[Signature]
Comments:
[Any further comments, suggestions, or observations regarding safety measures or prevention of future incidents.]
Signed by Parent/Guardian:
[Signature of Parent/Guardian]
[Date]

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PDF – 1 PDF – 2

Nursery Accident Form Template UK