Published 16 Jan 2023
What is an Incident Report Form?
An incident report form is a tool used to document any event that may or may not have caused injury, illness, and property and equipment damage in the workplace or worksite. It is crucial for an incident report form to be filled out at the time the incident occurs for an accurate recount of events. Information recorded in an incident report form is used to investigate the root cause. Identifying the root cause will help in establishing the appropriate control measures to prevent recurrence of the same incident.
An incident report template is a tool used to record incidents such as injuries, near misses, accidents, property damage and more. Use this template to record specific details of the incident and help organizations improve safety and security measures. Make the most of this checklist by following the points below:
- Identify the type of incident and provide details of person of injury, job and hazard/incident
- Take or attach photo evidence of incident, environment, person(s) involved
- Gather witness statements and capture digital signature
- Sign off with digital signature of person reporting
In this article
- Why Use Incident Report Form Templates?
- Types of Incident Reporting
- How do you Write an Incident Report?
- Incident Report Example
- What is SafetyCulture (formerly iAuditor) and how can I use it with an Incident Report Template?
- Top Incident Report Forms
Why Use Incident Report Form Templates?
A good incident report should state all the essential information about the accident or near-miss. Using an incident report form is important in identifying and understanding what caused the incident and how to prevent it from recurring. Incident report templates should be completed as soon as possible or during end-of-shift reports to preserve key details that are needed for insurance and regulatory purposes such as recording OSHA 300 forms.
Types of Incident Reporting
Here are two types of incident reporting that can help you create a more comprehensive report:
Here is the most vital information that you need to collect for the incident report:
- Type of incident
- Names of affected people
- Immediate Supervisor
- Statement of the affected people
- Context of the event
- The motion of the affected people during the incident
- Injuries, severity, and treatment
- Hazards identified
- The root cause of the event
“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.”
How do you Write an Incident Report?
Writing an incident report in a systematic way helps the reporter gather all the necessary details to make the incident report accurate, factual, and serve as an essential document for further investigation and analysis and preparation for more efficient preventive planning. Here are four steps on how to write a good incident report form:
- Know what information to collect – having the right knowledge of what information you need to include in your incident report will greatly help you with the gathering of data in the most efficient way. 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.
- Gather the most accurate and factual data – incident reports are documents of an actual event. Providing the most accurate and factual information is the topmost responsibility of the reporter. Opinions, biased statements, and vague information should be avoided.
- Provide more evidence as possible – to help strengthen the validity of the incident report, providing photos and illustrations will support the statements given by all the people involved in the event.
- Get signatures before completion – getting signatures from the affected people and witnesses confirms that the incident report is undoubtedly true.
Incident Report Example
In case of an 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.
What is SafetyCulture (formerly iAuditor) and how can I use it with an Incident Report Template?
Paper-based incident reporting can be cumbersome and time-consuming to the reporter. With SafetyCulture, you can perform paperless incident reporting with the use of a mobile app and a web platform. All data can be stored in a secure cloud and can be accessed anytime, anywhere. With SafetyCulture, you can:
- Replace incident report paper forms with a phone and tablet
- Easily attach photos to your incident reports
- Automatically save PDF reports online to the cloud. No more scanning and faxing
- Secure storage and audit trail of all incident reports for regulatory purposes
- Capture digital signatures and witness statements
To help you get started, here are a collection of the digital incident report forms you can download and customize for free.
Top Incident Report Forms
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. The report should capture whether the near miss was a result of an unsafe act, unsafe condition, unsafe equipment or unsafe use of equipment. Using SafetyCulture you can capture photo evidence with annotations of the surrounding environment or persons which led to the near miss being reported. A completed copy of the near miss report can be generated with SafetyCulture on-site and submitted to your relevant safety department. Browse more near miss report templates.
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 needed regarding the injury, witness statements and indicate if emergency services were contacted.
A workplace incident report is used to record any event in the organization that involves accident, injuries, or property damage. Use this template to document the type of incident that occurs in the workplace including near misses, sentinel events, adverse events, and no harm events. This would help the organization to keep track of the frequent causes of incidents to assess safety improvements in the workplace.
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.
This incident investigation template can be used to help conduct a root cause analysis following an incident or near miss at a worksite or workplace. Use this to help gather necessary facts and general background information of the incident. There is space to capture relevant environmental, equipment, system, and people factors that may have contributed to the incident. Finally identify and record the relevant steps to take action to fix all the factors that contributed to the incident, starting with the primary cause/s and working through each of the contributing and underlying causes. Browse more accident investigation report templates.
A workplace incident report form is a tool used by any staff to record incidents that caused injuries within the workplace. Indicate the individuals involved and the injuries sustained. Using this checklist can also document workplace violence and be helpful in compensation, insurance claims, and court cases.
An employee incident report is a document used by organizations to record work-related injuries. Employee overseeing the work area where the incident occurred is responsible for investigating and filing an employee incident report. Use this employee incident report template to assist in gathering crucial incident information such as date and time, and location of damage or injury description and evidence (if possible), and witnesses.
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.
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.
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.