It is a document for gathering information and formally documenting workplace incidents. Any employee directly involved or as a witness to an incident can fill out this report form. It can be submitted to the HR (Human Resources) department, supervisor, manager, or the applicable authority as per your organization’s rules. This free comprehensive incident report form template has sections for all the personal and employment details, type of incident, detailed description of the incident, its causes, outcomes, and more. Recommendations and preventive actions regarding the incident can also be listed.
This template is user-friendly with checklists and easily editable text fields. The main sections of this template are:
The first section allows you to add your personal and employment details. The type of incident that you are going to report can be checked, that might be an injury, sickness, near miss (any event that could harm but did not harm), or property damage. Furthermore, you can add the date, time, and location of the incident.
A section is provided to write a detailed description of the incident. Here, you can write in-depth information about the incident.
Similarly, the causes of an incident can be written these may be equipment malfunction, human error, or any other as per your situation. Consequences of incidents can also be mentioned which may include, illness, injury, or property damage as per the context.
A section is provided to write the medical and treatment details if you need it. You can mention the nature of injury or illness that has been caused due to the incident in the workplace, and the doctor’s name can also be mentioned.
Witness details can also be entered if there were any witnesses at the time of the incident.
Based on your experience and observations, you can provide some recommendations or preventive actions regarding the incident that occurred, to avoid such unpleasant events in the future.
A section is provided for the supervisor’s review, where they can write comments and feedback, including the actions that have been taken, after the incident took place.
At the end of this template, space for the supervisor’s and employee’s signature is provided with the dates.
Workplace incident reports are created to provide an appropriately structured and standard medium to document incidents in the workplace, it can also help analyze such events, assisting in risk management and further improving workplace safety and legal compliance.
This template is professionally designed, user-friendly with an intuitive layout, and is available in multiple file formats, such as ODT, DotX, DocX, and Google Docs. It provides you with checklists and facilitates your incident report form creation in the workplace.
