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    CTG-MRF-SOP ir form

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    IR - Form

    Uploaded by

    Mohammad Neshat Fazli
    6 views3 pages
    CTG-MRF-SOP ir form

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    © © All Rights Reserved

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    CTG-MRF-SOP ir form

    Copyright:

    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
    Download as docx, pdf, or txt
    6 views3 pages

    IR - Form

    Uploaded by

    Mohammad Neshat Fazli
    CTG-MRF-SOP ir form

    Copyright:

    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
    Download as docx, pdf, or txt
    You are on page 1of 3

    CTG INCIDENT REPORTING & INVESTIGATION

    Section A: Background

    Client, Project, Location


    Date and time of Incident
    Name of Person Reporting
    Incident
    Witnesses to the Incident

    Section B: Severity Rating (All incidents which are risk rated as a level three or four incident must be reported to the
    Executive Leadership Team and the Operations and Security Manager (as soon as practical). Please select:

    4. Life threatening (or fatality) or project closure and/or reputational damage

    3. Significant impact: non-life threatening bodily harm and/or damage to the project,
    Please select client or CTG reputation; significant service delivery issues
    the relevant
    category 2. Some impact: minor bodily harm and/or minor impact on business continuity or
    reputation
    1. Minor impact (no bodily harm, no impact on business continuity or service
    delivery)

    Section C: Type of Incident

    Behaviour Health related


    Customer Service
    Injury
    related
    Damage or theft
    Category Road related incident
    related
    Discrimination Security related
    Ethics Work error/mistake
    Good governance Other

    Section D: Details of Person Involved in Incident (indicate if non person related)

    Name Employee
    Position Consultant / Contactor
    Telephone Client
    Category
    Email Visitor
    CTG number Other: specify
    CTG account manager Non Person Related

    XXX
    CONFIDENTIAL 1
    Section E: Incident reporting

    Incident Reported to (indicate all whom the incident was reported to)

    Time Incident Reported Method of Phone Email Verbal


    Reporting

    Section F: Description

    Description of Incident

    Immediate Remedial Action Taken

    Section G: Investigation

    Incident Review (Summary of findings, focus on root cause and addressing any underlying issues)

    Reviewed by:

    Section H: After action review (this section is MANDATORY when an incident has severity rating of 3 or 4)

    Lessons learned

    Positive aspects

    CONFIDENTIAL 2
    Section I: Next Steps

    Follow up actions
    Action Who By Date Completed
    Enter date .
    Enter date .
    Enter date .

    CONFIDENTIAL 3

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