Template

ECI-Automation Incident Investigation Form

by Dave Wilson, from the Community

20+

Standardized incident investigation form for ECI-Automation projects and worksites. Capture incident type (injury, near miss, spill, property damage), timelines, affected body parts, equipment and tools, witness statements, and root cause analysis (5 Whys). Includes sections for site details, managers and safety contacts, training verification, photos, diagrams, environmental reporting, and corrective actions with responsible parties and due dates.

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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

About author

Community

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
Full Incident Investigation and Report
This incident investigation template helps teams collect evidence, document incident details, and perform root-cause analysis for hazards, near-misses, accidents, injuries, and property damage. It includes sections for timelines, weather conditions, evidence and attachments, vehicle and equipment logs, damage records, people involved and statements, injury classifications and affected body parts, corrective actions, and sign-off. Use it to create a thorough, compliant investigation report that goes beyond an initial incident report and supports prevention and follow-up.
by Craig Lee, from the Community
Downloads: 10+
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Template
UMA Incident Investigation Report
Use this incident investigation report to document workplace injuries from initial details to closure. Capture general information, employee and witness statements, incident type, injury nature and affected body parts, and medical treatment. Conduct root cause analysis with the 5 Whys and record surface causes. Plan immediate, short term, long term, and system improvement actions with owners and due dates. Attach photos, sketches, interviews, and diagrams. Managers review follow up actions and confirm completion to close the report and return it to the safety team.
by Joshua Davis, from the Community
Downloads: 0
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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
Downloads: 0
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Template
Incident Investigation Form
This incident investigation form helps supervisors and managers document workplace incidents the same day they occur. Capture incident type, department, location, date and time, witness details, and photos. Assess injury details including body part affected and nature of injury or illness. Identify causal and basic causes, perform a 5 Why root cause analysis, and note immediate corrective actions. Record OSHA classification, property damage, near misses, and high-potential events to support compliance and continuous improvement.
by Tyler Bonzo, from the Community
Downloads: 0
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Full Incident Investigation and Report

This incident investigation template helps teams collect evidence, document incident details, and perform root-cause analysis for hazards, near-misses, accidents, injuries, and property damage. It includes sections for timelines, weather conditions, evidence and attachments, vehicle and equipment logs, damage records, people involved and statements, injury classifications and affected body parts, corrective actions, and sign-off. Use it to create a thorough, compliant investigation report that goes beyond an initial incident report and supports prevention and follow-up.

by Craig Lee, from the Community

10+

Get

Template

UMA Incident Investigation Report

Use this incident investigation report to document workplace injuries from initial details to closure. Capture general information, employee and witness statements, incident type, injury nature and affected body parts, and medical treatment. Conduct root cause analysis with the 5 Whys and record surface causes. Plan immediate, short term, long term, and system improvement actions with owners and due dates. Attach photos, sketches, interviews, and diagrams. Managers review follow up actions and confirm completion to close the report and return it to the safety team.

by Joshua Davis, from the Community

Get

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

Get

Template

Incident Investigation Form

This incident investigation form helps supervisors and managers document workplace incidents the same day they occur. Capture incident type, department, location, date and time, witness details, and photos. Assess injury details including body part affected and nature of injury or illness. Identify causal and basic causes, perform a 5 Why root cause analysis, and note immediate corrective actions. Record OSHA classification, property damage, near misses, and high-potential events to support compliance and continuous improvement.

by Tyler Bonzo, from the Community

Get

ECI-Automation Incident Investigation Form

About author

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Full Incident Investigation and Report

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Full Incident Investigation and Report

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