Section: Which section do you belong to?

Group: Which group do you belong to?

Date: What is the date of the deviation?

Place: Where did the deviation happen?

Notice of deviation: Describe what occured?

Immediate actions: What immediate actions were carried out?

Cause: Why did it happen?

Requests: Do you have any requests to how the deviation should be handled?

Contact Info (email): Write your own contact information if you want to be contacted on an later occasion. Note that you will still be able to follow the deviation if this box is left empty. If you leave the box empty, you will stay anonymous.

Extra accesses: Who do you want to see the deviation? The HSE coordinator will always see the deviation. Note that you MUST check extra accesses if you want others to also be able to view and handle the deviation.

Extra info: Is there anything else you would like to add?