Template

Child Injury Report Template Form 323

by Daniel Burgess, from the Community

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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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
Incident, Injury, Trauma and Illness Record
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.
by Mark Whyte, from the Community
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Template
Work Injury Report Template
Use this Work Injury Report template to document workplace incidents thoroughly and consistently. Record employer and employee details, date and time, location, type of injury, body part affected, activities at the time, equipment involved, and a narrative of how the event occurred. Log treatment provided, healthcare providers, hospitalization, witness details, and return to work dates. Support internal reporting, workers compensation, and safety compliance across industries.
by Dan Elwell, from the Community
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Template
First Aid Medication Administration Record
This First Aid Medication Administration Record template helps schools and childcare centers accurately document the administration of medication to a child. Capture the child’s details and date of birth, medication name and expiry, correct dosage, and method of administration such as oral, eye or ear drops, inhaler, topical, injection, or other. Record the date and time given, last administration, and when the next dose is due or under what circumstances it should be administered. The form supports witness verification, requires separate staff and witness signatures, and includes parent acknowledgment to ensure transparency and safety. Use this template to standardize documentation, reduce errors, and maintain compliance with center policies.
by Sophie May, from the Community
Downloads: 10+
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Template
Behaviour and Concern Report Form
Use this Behaviour and Concern Report Form to document student accidents, incidents, or behavioural concerns in schools or childcare settings. Capture key details such as the name(s) of child involved, description of the incident, actions taken, and required follow-up. Record the staff member attending and collect parent or caregiver signatures, with options for multiple signatures when needed. Standardize reporting to improve communication, accountability, and timely resolution across your education environment.
by Rochelle Raddoc, from the Community
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Child Injury Report Template Form 323

With SafetyCulture you can

Digitize team workflows

Reduce manual errors

Create and share inspection reports

About author

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You might also like

Incident, Injury, Trauma and Illness Record

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