This injury report form can be used to record work-related injuries, causes, and actions taken to address them. It follows the Occupational Safety and Health Administration (OSHA)'s framework for reporting occupational injuries, illnesses, and incidents from an employee perspective.
About author
Free 1,000+ Workplace Checklists & Templates created by the SafetyCulture team.
You might also like
Templateby SafetyCultureOSHA Form 300A
This OSHA Form 300A Summary of Work-Related Injuries and Illnesses has been converted into an SafetyCulture digital template. This form should be completed as an annual record of total injury case and type information as well as time lost.
87 downloadsGet- Templateby SafetyCulture
OSHA Form 301
This OSHA Form 301 Injuries and Illnesses Incident Report has been converted into an SafetyCulture digital template. This report is one of the first forms you must fill out when a recordable work-related injury or illness has occurred.
122 downloadsGet - Templateby SafetyCulture
IT Incident Report Template
Use this template to report incidents concerning the server, the server room, and other IT-related incidents. Use your mobile device to take photo evidence and record if there's damage to property or injury to staff.
195 downloadsGet - Templateby SafetyCulture
Employee Incident Report
Employees can use this form to report all work related injuries, illnesses or near miss events no matter how minor. This template should be completed by employees and reviewed by a supervisor as soon possible after an incident occurs.
455 downloadsGet