Digital Injury Report Forms

Proactively report workplace injuries from your mobile device using digital injury report forms.

worker reports an injury in the forklift area|Injury Report Form|Injury Report Form Sample Report

What is an Injury Report Form?

An injury report form is a tool used to document injuries that have occurred in the workplace and similar settings. It captures vital details about the injured person, the circumstances surrounding the injury, and any immediate actions taken. Employees can submit this form to their managers as a formal record of the injury incident.

Why is Timely Reporting Important?

Timely reporting of injuries and similar workplace incidents is crucial to workplace safety and promoting a culture of safety for many reasons. For one, it swiftly informs supervisors and relevant authorities about an injury that has fallen upon an employee. This way, the injured individual can receive the assistance they need, may it be through medical treatment or preventive measures.

In addition, filling out an injury report form in the soonest time is key to obtaining an accurate account of the incident. This practice allows employees to capture all essential details while they’re still fresh in the memory of the individuals and witnesses involved. Having a reliable injury record can aid in resolving any subsequent legal and insurance disputes.

Lastly, employers can use these accounts to identify trends and patterns in their organization or work environment. By consistently documenting and analyzing reported incidents, they can spot recurring issues or conditions that put their employees at risk. This, in turn, allows them to make informed decisions about preventive measures and safety protocols to reduce the likelihood of future accidents and injuries.

What to Include in an Injury Report Form

An employee report of injury form gives employers and authorities an overview of the injury, its potential causes, and actions taken. For a comprehensive account of the injury, the form should contain the following items:

  • Employee name
  • Job title of the employee
  • Supervisor name
  • Date and time of reporting
  • Date and time of injury
  • Name(s) of witness(es), if any
  • Communication with the supervisor
  • Site/location where the injury occurred
  • Incident description
  • Cause(s) of the injury
  • Injured body part(s) and description
  • Actions taken (e.g., doctor’s visit)
  • Previous injuries, if any
  • Name and signature of the employee
  • Name and signature of the supervisor

The image below shows an example of a digital injury report form for your reference:

Do’s and Dont’s When Filling Out This Form

Just like with incident reporting, it’s important to keep in mind the following best practices and common mistakes to avoid when writing an injury report form:


  • Report the injury to the supervisor as soon as possible after it happens.
  • Give a detailed account of the incident, including the date, time, location, and a thorough description of how the injury occurred.
  • Stick to the facts for more accurate documentation of the case.
  • If there are witnesses, include their statements in the injury report.
  • Seek urgent medical care to ensure that the injury is diagnosed and treated properly.


  • Fabricate or exaggerate the information written in the report.
  • Speculate or assign blame without concrete evidence.
  • Attempt to diagnose the injury unless you’re a trained medical professional.
  • Leave out essential details or have blank fields from the report.
  • Neglect to follow up on recommended actions from the employer or medical provider.

FAQs about Injury Report Forms

Generally, anyone who has witnessed or experienced an injury at the scene should fill out an injury report form. These individuals can include the injured employee, their supervisor, safety officers, or any other personnel responsible for reporting these cases within the given context.

According to OSHA, employees must document “any work-related injury that results in loss of consciousness, days away from work, restricted work, or transfer to another job.” It includes injuries that need treatment beyond first aid, with special provisions for injuries involving sharp objects and hearing loss.

In most cases, injury reports must be completed within 30 days after the incident to ensure that the employee receives compensation benefits due to the injury. The time frame can be shorter in cases of severe injuries. Hospitalizations, amputations, and eye loss must be reported within 24 hours, while fatalities must be alerted within 8 hours.

After accomplishing the injury report form, the person or department responsible for managing incidents will review the information. They may initiate an investigation, assess the severity of the injury, and determine the next steps (e.g., medical treatment, safety measures). They may also reach out to the incident reporter for further information.

Leizel Estrellas
Article by
Leizel Estrellas
Leizel Estrellas is a content writer and researcher for SafetyCulture. Her academic and professional training as a researcher allows her to write meaningful articles that create a lasting impact. As a content specialist, she strives to promote a culture of safety in the workplace through accessible and reader-friendly content. With her high-quality work, she is keen on helping businesses across industries identify issues and opportunities to improve every day.

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