Members are reminded that they are required to inform the Club’s insurers, as soon as possible, of any incident that may result in a third party claim. Prompt completion of this form and return to the BSAC discharges this obligation. Members and others may also have private insurance obligations.

All military JSAT Diving divers should use the process detailed in JSP 286.

Agency_logosAll personal information will be dealt with in compliance with BSAC's Incident Reporting Data Policy

All fields marked with * are required.

Details of incident

Please indicate date by DD/MM/YYYY

Please use the following format 24hr hh/mm

Geographical Location
Incident Location

Please select one location only

Please use format Degrees - Minutes - Decimal. With either N/S. eg 53º 17'.289 N

Please use format Degrees - Minutes - Decimal. With either W/E. eg 002º 53'.894 E

Organisation of Dive

Please select one dive only

Dive details when incident occured
Decompression conducted on Incident Dive

Please use the following format 24hr hh/mm

Details of previous Dive 1
Decompression conducted on previous Dive 1

Please use the following format 24hr hh/mm

Details of previous Dive 2
Decompression conducted on previous Dive 2
Type of Incident and factors involved

Please tick all relevant boxes.

Incident Factors
Rescue Action
Dive type
Dive Conditions
Contributing Factors
Emergency Services Involved
Decompression Incidents
*Option to scan/upload dive profile and other documents at the end of the form
Details of individuals involved
Person A

All personal information provided will be dealt with in compliance with our Privacy Policy

Gender of persons involved in the incident

This information will NOT be normally be published in the incident report unless directly relevant to the incident and then only with the express approval of the individual (eg following a DCI being diagnosed with a PFO)..

Please select

Gas mixture being used

Indicate if used for the DIVE, or if only for decompression STOPS

Nitrox

Indicate if used for the DIVE, or if only for decompression STOPS

Nitrox

Indicate if used for the DIVE, or if only for decompression STOPS

Nitrox

Indicate if used for the DIVE, or if only for decompression STOPS

Please specify

CCR

Indicate if used for the DIVE, or if only for decompression STOPS

Please select your diver grade

Please specify

Please select your instructor grade

Please specify

*Number of dives at date of incident

dd/mm/yyyy

Person B
Gender of persons involved in the incident

This information will NOT be normally be published in the incident report unless directly relevant to the incident and then only with the express approval of the individual (eg following a DCI being diagnosed with a PFO)..

Please select

Gas mixture being used

Indicate if used for the DIVE, or if only for decompression STOPS

Nitrox

Indicate if used for the DIVE, or if only for decompression STOPS

Nitrox

Indicate if used for the DIVE, or if only for decompression STOPS

Nitrox

Indicate if used for the DIVE, or if only for decompression STOPS

Please specify

CCR

Indicate if used for the DIVE, or if only for decompression STOPS

Please select your diver grade

Please specify

Please select your instructor grade

Please specify

*Number of dives at date of incident

dd/mm/yyyy

Person C
Gender of persons involved in the incident

This information will NOT be normally be published in the incident report unless directly relevant to the incident and then only with the express approval of the individual (eg following a DCI being diagnosed with a PFO)..

Please select

Gas mixture being used

Indicate if used for the DIVE, or if only for decompression STOPS

Nitrox

Indicate if used for the DIVE, or if only for decompression STOPS

Nitrox

Indicate if used for the DIVE, or if only for decompression STOPS

Nitrox

Indicate if used for the DIVE, or if only for decompression STOPS

Please specify

CCR

Indicate if used for the DIVE, or if only for decompression STOPS

Please select your diver grade

Please specify

Please select your instructor grade

Please specify

*Number of dives at date of incident

dd/mm/yyyy

Person D
Gender of persons involved in the incident

This information will NOT be normally be published in the incident report unless directly relevant to the incident and then only with the express approval of the individual (eg following a DCI being diagnosed with a PFO)..

Please select

Gas mixture being used

Indicate if used for the DIVE, or if only for decompression STOPS

Nitrox

Indicate if used for the DIVE, or if only for decompression STOPS

Nitrox

Indicate if used for the DIVE, or if only for decompression STOPS

Nitrox

Indicate if used for the DIVE, or if only for decompression STOPS

Please specify

CCR

Indicate if used for the DIVE, or if only for decompression STOPS

Please select your diver grade

Please specify

Please select your instructor grade

Please specify

*Number of dives at date of incident

dd/mm/yyyy

Details of any equipment IMPLICATED in the cause of the incident

Please only tick items which CONTRIBUTED to the incident/accident

Diving equipment
Boat and boating equipment
Equipment details

If equipment failure/malfunction/design was IMPLICATED in this incident please provide details

Written Description

Please provide a written description of the events of this incident or upload a word file

All personal information provided will be dealt with in compliance with our Privacy Policy 

Please submit reports by diver’s partners, dive manager and any other witnesses together with a summary of the incident leading to the accident. Copies of statements given to the police or other authorities should also be included. Please enclose any press cuttings, inquest report, etc.

Once you have submitted this form you will receive a confirmation e-mail with an incident number. You will then be able to send any other correspondence via that e-mail if required.

If you have created your written description in word you can upload it from here.

You can screen capture your dive profile from your software or export it as a PDF file

Please tick one box only

Report submitted by

This email address will be used to confirm receipt of an Incident Report and an Incident number and may be used to request additional information

Please indicate date by DD/MM/YYYY

To print this form before submitting

If you would like to print a copy of the form for your reference, please use the small print icon below or alternatively at the top and foot of the page.

(Note if you cannot see all the text in the box use the line in the bottom right of the box to expand it)

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Verification

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