Survey form

    Please fill in the following form for each individual incident/accident and the measures taken to prevent it in future


    1. Kind of incident:

    2. When did the incident occur?

    Which machine?

    3. Where did the incident happen?

    3a. Please fill in a short description (Type/Model/Age)

    Description of incident

    4. Please fill in a short description of the incident


    5. Which improvements have been made in order to prevent this incident from occurring in future? Please fill in your measures.


    6. Please attach several photos of this incident
    You can upload up to 8 files (max. size 2 MB each)