FlexSpacez Incident Form

This form is NOT an admission of liability by the Company.

Please answer all questions fully and return form without delay.

1. Basic Information
2. Person Reporting
3. Description of Incident *
4. Type of Incident
5. Was Anyone Injured?
6. Property Damaged (if applicable)
₦
7. Evidence
20MB max per file
What type of Evidence is attached?
8. Additional Notes or Action Taken