INCIDENT/NEAR MISS INVESTIGATION REPORT and FIRST REPORT OF INJURY
by Jason Richey, from the Community
This document represents a detailed workplace incident investigation form designed to thoroughly document and analyze workplace accidents, injuries, and near-misses. The form includes essential sections for incident identification, employee information, injury details, investigation analysis, equipment involvement, training verification, and corrective actions. It also covers management review processes, insurance reporting requirements, and follow-up procedures. The form ensures proper documentation of workplace incidents while facilitating systematic investigation and implementation of preventive measures. Key components include incident location details, witness statements, PPE verification, and management sign-offs, making it a crucial tool for maintaining workplace safety standards and regulatory compliance.
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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.