Template

Incident, Injury, Trauma and Illness Record

by Mark Whyte, from the Community

This incident, injury, trauma and illness record template helps education and childcare services document essential details when a child is harmed or unwell. Capture child information, incident time and location, witnesses, nature of injury or illness, first aid and treatment provided, emergency services attendance, and steps taken to prevent recurrence. Record notifications to parents or guardians, directors or coordinators, regulatory authorities, and other agencies, plus parental acknowledgement. Use this form to support regulatory compliance, improve safety, and strengthen reporting practices.

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

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
Monkey Bars Incident Injury, Trauma and Illness Record
Use this incident, injury, trauma and illness record to document monkey bars related events in early learning services. Capture child details, circumstances, nature of injury, first aid and actions taken, notifications, and follow up requirements. Supports compliance with Education and Care National Regulations 85, 86, 87 and 176, parent acknowledgements, and supervisor sign off.
by Cass Dodd, from the Community
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Child Injury Report Template Form 323
Use this child injury report template to record incidents in education and childcare settings. Capture child details such as name and date of birth, describe the circumstances of the injury, note location, date and time, and list any objects or structures involved. Include witness signatures, the first aid provided, and educator details, then obtain parent acknowledgement. This customizable template helps standardize reporting, improve communication with families, and support compliance and accurate record keeping.
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Use this injury investigation form to document a first report of injury or illness. Capture employee and incident details including date, time, location, injury type, and body part affected; eyewitness information; environmental conditions; underlying factors such as PPE use, equipment issues, and training gaps; and recommended corrective actions. Attach photos or media, assign actions, and record investigator and supervisor sign-off. Suitable for construction and other industries to support incident reporting and root cause analysis.
by Jonathan Nixon, from the Community
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MGI-INJURY AND ILLNESS REPORT
2019 This Injury and Illness Report is one of the first forms you must fill out when a recordable work-related injury or illness has occurred.
by Hugo Salmeron, from the Community
Downloads: 40+
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Incident, Injury, Trauma and Illness Record

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Monkey Bars Incident Injury, Trauma and Illness Record

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