What is an Incident Report Template?
An incident report template is a standardized form used to document unprecedented events in the workplace like injuries, incidents, accidents, and even near misses. An incident report form must be filled out at the time the incident occurs for an accurate recount of events. Information recorded with this template is used to investigate the root cause of the incident—establishing the appropriate control measures to prevent its recurrence.
What to Include in an Incident Report Template
Following the outline of an incident report form, the first thing you would want to collect are fundamental information. With this, what are the items to write in an incident report template?
- Name of the person preparing the report
- Names and position of the people involved
- Location
- Incident details such as date and time, description of the incident, injuries (if any), status and condition of the environment, and cause of the incident
- Photos related to incident
- Actions taken to ensure the incident does not recur
- Comments and recommendations
- Sign-off
Incident Report Format
A well-structured incident report generally includes the following key elements:
- Introduction – The first part of the incident report covers the who, what, when, and where of the incident.
- Body – Talk about the incident from start to finish, ensuring details are laid out in chronological order to avoid confusion.
- Conclusion – Was the incident resolved? How? If the incident was not resolved, explain why, and provide the steps that need to be taken in order to resolve it.
- Sign off – Include the full name and signature of the incident report writer for accountability and record-keeping.
How to Write an Incident Report with a Template
Knowing how to write an incident report helps the reporter gather all the necessary details to make the incident report accurate and factual. Here are three steps on how to write a good incident report using a template with their examples:
1. Know what information to collect
A checklist can be a helpful guide to avoid missing out on important details especially at times when you need to submit the incident report as soon as it is needed.
2. Gather the most accurate and factual data
Providing the most accurate and factual information is the topmost responsibility of the reporter. Opinions, biased statements, and vague information should be avoided.
3. Provide as much evidence as possible
Add photos and illustrations to strengthen the validity of the incident report and support the statements given by witnesses.
Incident Report Examples
The following are a few real-life examples of incident reporting in different aspects of workplaces:
General Incident Report Sample
“On Monday morning, September 4, 2020, at 7 a.m. in Cehenna Express. located in 5th Avenue, Pandemonium, one of the warehouse staff (Harvey Kinkle) slipped while transferring a piece of 95-lbs equipment to a nearby stock room. Upon further analysis, the root cause of the incident is believed to be the wet flooring due to a leaking water tank in the same location. Adding the fact that Harvey has poor vision, he carried the load himself without seeing the water on the floor.
When Harvey fell, his colleague, Nick, who is about to enter the warehouse, heard a nearby bang that urges him to check what happened. Nick quickly ran to help Harvey. After reporting the incident to the shift supervisor, Mary Wardwell, they decided to call the Pandemonium hospital for an ambulance. Harvey said his head fell badly to the ground when he lost his balance, causing severe headaches, although there was no blood from his injuries.
Harvey was admitted to the Pandemonium General Hospital and a skull fracture was confirmed. Harvey will be out of work for 2 months.
The supervisor is currently working with the safety personnel (Edward Spellman) to evaluate the condition of the floor, the location and condition of the water tanks on the floor, and the lighting systems installed. Also, an eye medical test will be administered to all Cehenna Express staff.”
Fall Incident Report Sample – Construction
“Whilst working as part of the roofing crew on a large residential project, the apprentice was required to climb the 8-meter-high scaffolding to retrieve some tools from the roof at the end of his shift. He put the tools in a bucket and started to climb down with the bucket in his hand. He thought it would be faster to climb the outside of the scaffolding rig. As he climbed onto the outside of the scaffolding, he lost his footing and fell 8 meters to the ground.
The roofing crew team leader called an ambulance as the first aider attempted to revive him. The apprentice was in a coma for three months and after a lengthy period in therapy was eventually able to walk with aids. He was unable to work in the construction industry as a result of his injuries.
The H&S manager investigated the accident using witness statements from the roofing crew and a review of site documentation. The root cause was determined to be lack of adequate supervision and poor communication of safety site rules.”
In the event involving an injury, you can use an accident report form as your injury report form to capture all important information and immediately report the accident. Here’s a sample incident report in a PDF format.
FAQs about Incident Report Templates
What are the 5 elements of an incident report?
How do I create an incident report template?
How soon should an incident report template be filled out after an incident?
Who should fill up the incident report template?
What is the best way to create and manage an incident report template?
Efficient Incident Reporting with SafetyCulture
With a digital solution such as SafetyCulture you can perform paperless incident reporting from both mobile devices and laptops, anytime and anywhere. SafetyCulture is an operations platform that offers premade editable and fillable incident report templates in the Public Library as well as a smart form builder for you to create your own templates from scratch. Additionally, with SafetyCulture, you can also do the following:
- Customize effortlessly: Tailor templates with specific needs by incorporating custom logic into digital checklists
- Empower your team: Invite your team members to utilize and explore the platform, enabling them to experience its capabilities
- Never miss an audit: Schedule inspections that notify all relevant personnel to ensure that no check-ins are overlooked
- Keep everyone informed: Generate comprehensive reports that are easily shareable with leaders, team members, and other relevant stakeholders
Related Incident Report Templates
Fire Incident Report
Use this fire incident template for notification of any fire or fire-related incidents. Example incidents include building and vehicle fires, premises evacuation, alarm activation, obstructed exit routes, premises evacuation or accidental fire notifications. There is space to record the building location, type of fire incident being reported, photo evidence of damage or obstruction and contact details of persons involved in the incident. It can be used by the Health and Safety Department or Facilities Management divisions and the generated report can be shared with regulatory and fire departments. You can customize this template to suit your property specifications and include branding and logos. Browse for more fire safety checklists.
Vehicle Incident Report
Use this vehicle incident report during first response on the scene. With this as your vehicle incident report template, quickly gather the facts and collect evidence about an incident, vehicle damage, accident, or injury. Conduct full investigations quickly with this incident report template. Log all damage, parties involved, witness statements and photo evidence at the scene on your mobile device. Browse for other vehicle inspection checklists here.
General Staff Incident Report Form
This General Incident Report Form can be used to report and document accidents, incidents, near misses or equipment damage involving members of staff. Capture employee details and then document all near miss or injury details. Take photos of any equipment damage. The template has space to record detailed action plans and steps to prevent incidents from occurring again.
Event Incident Report Form
The event incident report form can be used during outdoor or indoor public events. Event planners, supervisors and safety officers should complete this form immediately after an incident occurs. Gather information of the person(s) injured and relevant witness statements and obtain electronic signatures. Browse for more event safety checklists.
Accident Report Form
An accident injury report form is used to record accidents that have led to injured employees and persons in the workplace, on-site or in the field. Use this accident report form to provide key details regarding the injury and witness statements, and indicate if emergency services were contacted.
Workplace Incident Report Form
A workplace incident report form is a tool used by any staff to record incidents that caused injuries within the workplace. Using this checklist can also document workplace violence and be helpful in compensation, insurance claims, and court cases.
Security Incident Report Template
Use this security incident template allows users to document security issues by filling in details such as the date and time of the incident, description, location, evidence, persons involved, police involvement, injuries, property damage, and corrective actions. Once completed, the report can be submitted to management.
Near Miss Report
Use this near miss report form to capture a potential hazard or incident that has not resulted in any personal injury or property damage. It can be completed by anyone wishing to report a near miss.
Construction Incident Report Template
Use this construction incident report template specifically designed to report issues encountered at a construction work site. It includes sections for general information such as the injured person, the nature of the injury, medical treatment, witness details, and supervisor notification.
IT Incident Report Template
An IT incident report template is a prerequisite tool submitted to an IT manager to begin an investigation into a specific incident. Use this template to identify the nature of the incident and its potential impact.
Employee Incident Report
An employee incident report is a document used by organizations to record work-related injuries. Use this employee incident report template to assist in gathering crucial incident information such as date and time, location of damage or injury description, evidence (if possible), and witnesses.
Jona Tarlengco