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You have scanned an ACTION-CARD.
Press SEND to complete the registration.
Real incident
Yes
No
Is the QR code scanned to register for training or reading the Action-card®?
Training
Read AC
Enter your employee name or ID
No name
Dharmik
Murtuza
Jay
Vimal
Ivan
Other
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Number of replies with answer "Yes"
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Gamemaster or instructor tells you the number of replies with yes.
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Number of replies with answer "No"
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Gamemaster or instructor tells you the number of replies with no.
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Number of replies with answer "NA"
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Gamemaster or instructor tells you the number of NAs. NA means Not Applicable or Not Relevant.
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To the injured party: would it be OK if we register your full name and contact details for documentation purposes?
The information is stored for a maximum of one year and is only used so that you yourself, upon request, can subsequently document this incident.
Select
Yes
No
First name and surname of injured party
Phone number for injured party
Email address for injured party
For potential witness: would it be OK if we register your full name and contact details?
The information is stored for a maximum of one year and is only used in connection with any documentation of the accident.
Select
Yes
No
First name and surname of witness
Phone number of witness
Email of witness
If possible write a short note or comment on the critical incident that you just have helped acted upon.
You can also write a comment about the training or the ACTION-CARD here.
If possible, upload a picture of the area where the incident took place or other necessary documentation.
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When you have filled in this form correctly, you must press the “SEND” button and wait until “THANK YOU” appears on the screen.
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