Prototype intake form (separate from the signed-in MIS). Submissions with a matched premises record appear under Incoming; unmatched addresses under Awaiting premises. Open CPFSI prototype

Crown Premises' Incident Notification (CPIN)

* denotes a required field

Incident Number *

Date of Incident *

Time of Incident

Address of Premises

Premises Not in System or Not Found

If unable to find Premises in 'Address of Premises' field, please enter here.

Fire and Rescue Service

Point of Contact *

Fire Service Contact Email *

Stop Message

Incident Status *

Incident Dealt with by Staff - No Known Injuries Fire Service Fought Fire or Carried Out Rescues Injuries as a Result of Fire Serious or Fatal Injuries Suspected as Result of Fire

Please immediately call 0300 1233911 if you select 'Serious or Fatal Injuries Suspected as Result of Fire' (24hr phone line)

Description of Incident *

Message here... Please replace any codes with plain language

Password

Clear Form

Report received

Your submission has been saved for prototype testing. Inspectors can triage it in the main app.

Go to CPINs queue (sign in).