Safety

Incident Report Form

Comprehensive documentation of workplace accidents, injuries, near-misses, and safety incidents.

Format: PDF Size: 144 KB 1,000+ Downloads
Incident Report Form Preview

About This Template

The Incident Report Form is essential for documenting workplace accidents, injuries, near-misses, and property damage incidents. This template ensures complete information capture immediately following an incident, supporting OSHA recordkeeping requirements, workers’ compensation claims, and incident investigation processes. Proper incident reporting enables organizations to identify trends, implement corrective actions, and prevent future accidents. The form includes witness statements, immediate causes, environmental conditions, and preliminary root cause analysis, providing the foundation for thorough incident investigation and corrective action.

Key Features

Complete incident details and timeline
Injured person information and injury description
Witness statements and contact information
Environmental and equipment conditions
Immediate actions taken and medical treatment
Preliminary root cause and contributing factors

How to Use This Template

  • Complete the form immediately after any incident occurs
  • Document exactly what happened without speculation or blame
  • Collect statements from all witnesses while fresh
  • Record environmental conditions, equipment status, and PPE use
  • Document immediate actions taken and medical treatment provided
  • Use information for detailed investigation and corrective actions

Ideal For

Safety managers maintaining OSHA injury logs
Supervisors documenting workplace accidents
HR personnel managing workers

Common Use Cases

Documenting OSHA recordable injuries for 300 log
Recording near-miss events for proactive safety improvement
Supporting workers

Use this template in a live digital workflow

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