Date of incident

Date incident reported to JG:

Name of person reporting incident:

Passenger name:

Booking ref:

Tour Code/ Name

Detail whether incident occurred on COACH, HOTEL, EXCURSION or OTHER (if other give details)

Location, Address, Town, City

Who was affected? Name(s) of Passenger(s) involved

Contact Phone number of customer(s) or NOK

Brief Description of incident/injury. (inc. details of any medical asst given and any witnesses)

What action was taken? Has a record been made ie: Accident Book / Paramedic or hospital visit? Was an Ambulance called?

Please outline any follow up action required by JG!