Template

Hazard Report Form

by Alyssa Lopez, from the Community

10+

This hazard report form helps teams capture and manage workplace hazards quickly and consistently. Record when and where a hazard was identified, describe the risk with text and images, and assess severity and likelihood. Create and assign corrective actions with due dates, then verify control measures have been implemented by supervisors or managers. Use this template to standardize hazard identification, accelerate issue resolution, and reduce incident risk across worksites.

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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
Hazard Report Form
Use this hazard report form to: - Keep track of when and where the hazard was reported - Describe the hazard using text, images, and annotations - Determine the seriousness of the injury and the medical attention required - Create a corrective action plan to minimize hazard risk - Implement control measures for accident prevention
by SafetyCulture
Downloads: 700+
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Template
Hazard and Incident Report Form
Use this hazard and incident report form to record workplace hazards, near misses, and incidents in a consistent way. Log report and incident types, time and location, people involved, and witness details. Add photo evidence and assess risk by severity and likelihood to prioritize corrective actions. Capture root causes, assign follow up tasks, and track resolution to strengthen safety and compliance across your organization.
by Edward Abrahamsen, from the Community
Downloads: 10+
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Template
Workplace Hazard Report Form
This workplace hazard report form helps teams identify and report serious hazards at any site. Capture hazard details and reported date, name the site and manager, assess risk using a simple risk matrix to determine initial risk, and outline control actions to eliminate or mitigate the hazard. Track whether controls are implemented, record residual risk after action, assign a responsible person with a due date, and capture manager and CEO signatures to confirm completion. Ideal for ongoing facility safety reporting and incident prevention across industries.
by Wendy Worters, from the Community
Downloads: 0
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Template
Survey Lokasi Toko Ritel
This MC Hazard Report Form helps teams quickly identify and document hazards on site. Record when and where the hazard was found, describe the risk, assess likelihood and potential severity, and propose corrective actions. Add supporting photos with annotations for clarity, and include additional comments as needed. A supervisor section tracks whether controls and corrective actions have been implemented, with fields for completion date and signature. Ideal for construction safety workflows, this mobile-friendly form streamlines reporting and ensures timely follow-up.
by Jesse Greene, from the Community
Downloads: 10+
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