Plas Heli

Academi Hwylio Genedlaethol a Chanolfan Ddigwyddiadau

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Plas Heli Accident Reporting Form

Use this form to record an Accident which occured in the Plas Plas Heli Facilities

If an accident takes place you must record the details of the incident. This on-line form will hold your details in accordance with our Data Protection Policy - here
Only use this form if you have been directed here by Plas Heli.

The details wil be kept for future accident reviews and preventions.

If you are reporting an accident or incident that has affected someone under the age of 18 years old, you need to state your relationship with the injured person.

When you have completed this form you will receive an e-mail copy of your submission.

Please provide us with your name and details - sufficient for us to be able to contact you should this be necessary.

This is the details of the person reporting the accident - you can provide details of person/s affected by th eaccident later in the form.

Full Name(*)

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e-mail(*)

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Mobile Number(*)

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Home Telephone Number

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Postal Address

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Post Code

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(*)

I am the injured Party I am reporting an accident where another person was injured I am reporting an accident where a child (under 18years old) was injured Invalid Input

Name of Injured Person

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Contact details of person Affected if different form above

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Relationship to Affected Person

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Consent (*)

I consent to the above details being kept on the Plas Heli computer and paper file for the purpose of contact, receiving relevant information and renewal requests. Invalid Input