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3rd Party Safety / Near Miss / Incident / Accident Report -Heli Surveys
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* Indicates required question
Name
*
Your answer
Severity of event
*
Minor
1
2
3
4
5
Extreme
Potential Severity of event
*
How bad could the event have been?
Minor
1
2
3
4
5
Extreme
Date and time of event
*
MM
/
DD
/
YYYY
Time
:
AM
PM
Location of event
*
Your answer
Category of event
*
Choose
Airborne / Aircraft
Airport
Hangar
Vehicle
Ground Crew
Other
Aircraft registration (if applicable)
Just last 3 letters i.e. ZMH if it was VH-ZMH
Your answer
Customer (if applicable)
Your answer
People involved
*
Your answer
Details of event
*
Please describe the event in as much detail as possible.
Your answer
Injuries
*
Your answer
Follow ups / Actionable items / Suggestions to reduce likelihood of recurrence
*
Your answer
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