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Accident and Incident Investigation Form

by Agnes Borbely, from the Community

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This accident and incident investigation form helps teams document workplace events thoroughly. Capture incident details, exact location, date and time, witness statements, photos, and CCTV availability. Record injuries, first aid provided, hospital admission, work time loss, authorization, experience, and behaviors. Review risk assessments, safe procedures, environmental factors, safety devices, equipment or hazardous substances involved, training, and supervision. Identify immediate, underlying, management, technical, and root causes. Define remedial actions, track implementation, and complete manager sign off. Includes data protection notice.

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.