Template

Culligan Incident and Investigation Form

by Tiffany Argent, from the Community

10+

Use this combined accident and investigation form to log incidents across warehouses, manufacturing and logistics. Record incident details, persons involved, injuries and body part, PPE, first aid, witnesses, environmental conditions, and RIDDOR. Guide root cause analysis with 5 Whys or Ishikawa and assign corrective actions, sign offs and follow up to prevent recurrence.

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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
Accident and Incident Investigation Report Form
Use this investigation report form to document accidents and incidents thoroughly. Record event details, witnesses and evidence, injuries and first aid, authorization and training, risk assessments, environmental conditions, equipment and PPE, root causes, and corrective actions. Includes prompts for RIDDOR reporting and follow-up verification to help prevent recurrence.
by Chris Blair, from the Community
Downloads: 10+
Get
Template
Incident and Investigation Form
This comprehensive incident and investigation form standardizes workplace reporting from initial incident capture to closure. It guides teams to record time and location, people involved, injury type and body part, PPE requirements and compliance, immediate response, first aid, witness statements, and any available CCTV. It covers environmental and utility incidents, references RIDDOR reporting, and supports structured investigations using 5 Whys or Ishikawa to identify direct and root causes. The template prompts corrective and preventive actions, assigns responsibilities, tracks completion evidence, and requires sign-offs. Designed for warehouse, yard, office, and offsite logistics operations.
by Tiffany Argent, from the Community
Downloads: 10+
Get
Template
Accident Investigation Report HE051
This accident investigation report template (HE051) guides Health and Safety teams through a thorough incident review. Capture investigation details, incident location, date and time, injured person status, and injury type. Document first aid provided, treatment, witnesses, photos, equipment used, and site conditions. Evaluate PPE requirements and condition, immediate and contributing causes, and defenses that failed or worked. Use the 5 Whys to identify root cause, then assign corrective and preventive actions with owners and due dates. Record authorizations and sign-offs, and track reportability under RIDDOR. Use this form to standardize investigations and prevent recurrence.
by Tanveer Parkar, from the Community
Downloads: 10+
Get
Template
Incident Investigation & Root Cause Analysis
Use this incident investigation and root cause analysis template to document incident details, classify type and location, record contributing behaviors and conditions, and perform Heinrich quick analysis. Guide your team through 5 Whys and fishbone categories (People, Machine, Method, Materials, Environment, Measurement) to identify root causes, then define corrective actions, PPE, training, and safety coaching with evidence photos to prevent recurrence.
by Jerome Stevenson, from the Community
Downloads: 20+
Get

Accident and Incident Investigation Report Form

Use this investigation report form to document accidents and incidents thoroughly. Record event details, witnesses and evidence, injuries and first aid, authorization and training, risk assessments, environmental conditions, equipment and PPE, root causes, and corrective actions. Includes prompts for RIDDOR reporting and follow-up verification to help prevent recurrence.

by Chris Blair, from the Community

10+

Get

Template

Incident and Investigation Form

This comprehensive incident and investigation form standardizes workplace reporting from initial incident capture to closure. It guides teams to record time and location, people involved, injury type and body part, PPE requirements and compliance, immediate response, first aid, witness statements, and any available CCTV. It covers environmental and utility incidents, references RIDDOR reporting, and supports structured investigations using 5 Whys or Ishikawa to identify direct and root causes. The template prompts corrective and preventive actions, assigns responsibilities, tracks completion evidence, and requires sign-offs. Designed for warehouse, yard, office, and offsite logistics operations.

by Tiffany Argent, from the Community

10+

Get

Template

Accident Investigation Report HE051

This accident investigation report template (HE051) guides Health and Safety teams through a thorough incident review. Capture investigation details, incident location, date and time, injured person status, and injury type. Document first aid provided, treatment, witnesses, photos, equipment used, and site conditions. Evaluate PPE requirements and condition, immediate and contributing causes, and defenses that failed or worked. Use the 5 Whys to identify root cause, then assign corrective and preventive actions with owners and due dates. Record authorizations and sign-offs, and track reportability under RIDDOR. Use this form to standardize investigations and prevent recurrence.

by Tanveer Parkar, from the Community

10+

Get

Template

Incident Investigation & Root Cause Analysis

Use this incident investigation and root cause analysis template to document incident details, classify type and location, record contributing behaviors and conditions, and perform Heinrich quick analysis. Guide your team through 5 Whys and fishbone categories (People, Machine, Method, Materials, Environment, Measurement) to identify root causes, then define corrective actions, PPE, training, and safety coaching with evidence photos to prevent recurrence.

by Jerome Stevenson, from the Community

20+

Get

Culligan Incident and Investigation Form

About author

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Accident and Incident Investigation Report Form

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