Template

Invacor Incident Investigation Report

by Conrad Liles, from the Community

Use the Invacor Incident Investigation Report to capture essential details following injuries, property damage, vehicle or equipment incidents, and utility line strikes. The template guides teams through incident classification, dates, location, employee information, injury description and treatment, clinic details, and duty status. It also covers property, vehicle, equipment, and utility damage with prompts for DOT regulation, One Call tickets, locates, and preventive measures. Record event descriptions, contributing factors, corrective actions, attach photos and diagrams, and close out with signatures. Intended as an example to help standardize reporting across worksites.

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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 Investigation Report Template AES
Use this AES incident investigation report template to capture critical details after an event. Record incident date, time, location, and classification such as near miss, injury, property damage, or spill. Document employee information, injury and treatment, and any vehicle, equipment, or utility damage with One Call and DOT details. Add a brief narrative, complete a 5 Whys root cause analysis, and list corrective and preventive actions. Attach photos and diagrams, then close out with auditor name and signature.
by Juan Rivera, from the Community
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Template
Blanchette Field Services - Incident Investigation Report
This incident investigation report template helps construction and field service teams capture critical details after an event. Record incident date, time, location, classification, and parties involved. Document injury or illness, property, vehicle, equipment, and utility damage, including One Call details and DOT considerations. Guide investigators through root cause analysis with event sequencing and the 5 Whys, then define corrective and preventive actions. Attach photos and diagrams, and finalize with sign-off for accurate, compliant reporting and follow-up.
by Brandon McCurry, from the Community
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Template
Incident and Investigation Report
Use this Incident and Investigation Report template to capture critical WHS details after an event. Record incident type, location, dates, injured or ill persons, treatment, injury descriptions, dangerous events, electrical and environmental incidents, near misses, and property or vehicle damage. Collect evidence, witness statements, and photos, then complete investigation steps including PEEPO analysis, contributing factors, root cause, and corrective actions. Includes management notifications, sign-offs, and communication plans to support compliance with Work Health and Safety requirements and consistent reporting across teams.
by Angela Warren, from the Community
Downloads: 10+
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Template
STS Incident Reporting Form
A comprehensive incident reporting and accident investigation form tailored for job sites. Capture incident details including location, job number, dates and times, incident type, and whether emergency services responded. Record employee involvement, injury severity, body part affected, type of injury, medical treatment needs, and training status. Document witness statements, immediate corrective actions, and lessons learned. Track property damage, utility strikes, chemical spills, and vehicle incidents with driver details, vehicle information, diagrams, and photos. Include citations, drug testing status, and follow up actions to support safety compliance and continuous improvement.
by Kenneth Cole, from the Community
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Invacor Incident Investigation Report

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Incident Investigation Report Template AES

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Incident Investigation Report Template AES

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