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SAGGA SASA ASDA EPSASA SABISA TPMA SAFIERA SASEMA AAAMSA Fenestration

Glass Incident Register

Glass Incident Register

All fields marked (*) are required

The information contained in this register of your glass incident is provided for informational purposes only to improve the general safety of glass in manufacturing and installations for the general public, and should not be construed apportioning liability on any party whatsoever. This is a voluntary submission. We disclaim all liability for actions you take or fail to take based on any content on this site.

- I Accept and Understand *

Contact Details of Person Submitting this Incident*

Contact Details of Injured Person*

Age of Injured Person*

Date and Time of Incident

Address where incident occurred *

Building Classification *

Glazing type causing incident *

Nature of Injury

Cause of Injury

Can we contact you regarding this incident? *

Yes -
No -

Can we use this info for training or presentation? *

Yes -
No -

Upload pictures or any other documentation - (if applicable)