Incident report form
Date of incident
Time
Location
Reported by
Job or project
Report date
A starting point. Adapt it to your equipment, your procedures and the rules that apply to you.Free template from portalbaseai.com
Free template
An incident report form to fill out the same day.
Write down what happened, who was there and what you did right away. Then list what contributed and who fixes what. Print the sheet or save it as a PDF.
Also calledAccident report form, Workplace incident report, Injury report form, Safety incident report
Free to print, copy and change. It’s a starting point. Add the lines your equipment and your rules need.
How to use it
Three habits that make it worth filling out.
Step 1
Fill it out the same day
Details fade fast. Write it while people can still remember who stood where.
Step 2
Stick to what you saw
Describe the event, not the person. Fault gets sorted out later, after the facts are down.
Step 3
Give every fix an owner
An action with no name and no date doesn't get done. Check the list at the next safety meeting.
Do this on a phone instead of paper.
Report an incident on a phone, with photos and the people involved, no signal needed. Corrective actions get an owner and a due date, and the record is kept for you.
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Common questions
- What goes on an incident report?
- What happened, when and where, who was involved, who saw it, what was done right away, what contributed and what will change. Keep it factual.
- Does every incident get reported?
- Many sites want every injury, property damage event and near miss written down, even small ones. Your company procedure sets the rule. Whether an injury goes on the OSHA log is decided by the current recordkeeping rule, 29 CFR 1904.
- Who should review the report?
- The crew lead or supervisor reviews it first, then the safety lead. Follow your company procedure for who signs and how fast.
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Glossary
Recordable incident
A recordable incident is a work-related injury or illness that meets OSHA's criteria for the log, such as medical treatment beyond first aid.
Glossary
Incident investigation
An incident investigation is the structured look at what happened, why, and what to change, done after an injury, a near miss or damage.
Glossary
Corrective action
A corrective action is a specific fix, with an owner and a due date, that removes a hazard or the cause of an incident.
Glossary
First aid vs. medical treatment
First aid is minor, one-time care that isn't recordable. Medical treatment beyond first aid generally makes an injury recordable.