EVOLVE Accident Report Form

Use this EVOLVE accident report form template to document workplace incidents clearly and consistently. Record department, injured person and job title, date and time, and accident location. Describe the task being performed, injuries sustained, how the incident occurred, and any immediate actions such as first aid or stopping work. Capture witness names, equipment involved with ID, applicable safe working procedures such as standard operating procedures or COSHH, PPE in use, worker competence and training, and environmental conditions. Note any absence from work, outline recommendations to reduce risk, and record supervisor details. Complete sign off, indicate if further investigation is required, and attach the file to the health and safety report log.