Template

ACS Incident Report: Full Investigation Template

by Dave Hallett, from the Community

This comprehensive ACS Incident Report template helps teams document and investigate workplace incidents end-to-end. Capture incident details, severity, type, and timeline; note weather conditions; and attach evidence, equipment, vehicle, and damage logs. Record people involved with roles, statements, and injury details, including affected body parts. Plan corrective actions and perform root cause analysis using 5 Whys to identify contributing factors like PPE gaps, equipment defects, or unsafe procedures. Assess recurrence likelihood, document how causes were rectified, and complete sign-off and follow-up to close the investigation with a thorough report.

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With SafetyCulture you can

Digitize any process, procedure or policy

Eliminate mistakes made by paper-based processes

Create and share professional reports instantly

Confirm accountability and compliance with a digital log

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This community page makes available free workplace checklists and templates created by other users within the SafetyCulture community. SafetyCulture has re-published this content and where possible, has credited the original author. SafetyCulture has not verified the accuracy, reliability or suitability of any community content. You agree that your use of any of this content is in accordance with SafetyCulture’s Terms and Conditions.

Template
Incident Report: Full Investigation and Report
This comprehensive incident investigation template helps teams capture incident details, build a timeline, and attach evidence such as equipment, vehicles, damages, and other items. It includes structured logs for people involved, statements, and injury details with affected body parts. Teams can assess severity, medical attention, environmental conditions, and contributing factors. Root cause analysis prompts (including likelihood of recurrence) guide corrective actions and follow-up. Final sign-off fields ensure accountability and closure for thorough incident reporting.
by Mark Playforth, from the Community
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Template
Motor Mall Incident Report Full Investigation
Use this incident investigation report template to document incidents from first notification through root cause. Record incident details, timelines, environmental conditions, evidence and attachments, vehicle and equipment logs, damages, and people involved. Capture statements, injury types and body parts affected, and medical treatment. Perform root cause analysis, note contributing factors, and add corrective actions. Finish with sign off and follow up to close out the investigation.
by Liam Daniels, from the Community
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Template
WAFarmers Incident Report - Full Investigation and Report
Capture full incident details with this WAFarmers incident report and investigation template for agricultural operations. Log date, time, location, conditions, and a timeline of events. Attach evidence, and record equipment, vehicle, and damage details. Document people involved, statements, and injury types and affected body parts. Perform root cause analysis, assess likelihood of recurrence, and assign corrective actions. Conclude with sign-off and follow-up for compliance and continuous improvement.
by Gloria Moreno, from the Community
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Template
Incident Investigation Report Template
This comprehensive incident investigation report template helps teams capture the facts, evidence, and outcomes of workplace incidents from start to finish. Record incident details and timelines, document weather conditions, log evidence with photos, and track vehicles, equipment, damages, and other items. Capture people involved, witness statements and signatures, and detailed injury information including type and affected body parts. Conduct a structured root cause analysis using contributing factors and five whys to identify underlying causes and likelihood of recurrence. Plan and verify corrective actions and recommendations, then finalize with investigator and reviewer sign-offs and follow-up assignments. Ideal for construction and field operations seeking a thorough, repeatable approach to incident documentation and prevention.
by Mark Baylis, from the Community
Downloads: 10+
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ACS Incident Report: Full Investigation Template

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Incident Report: Full Investigation and Report

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Incident Report: Full Investigation and Report

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