Use this Incident/Injury Report Form to document workplace events quickly and accurately. Capture personal and incident details, supervisor and WHS manager notifications, injury type and affected body part, treatment and time lost, and a full investigation checklist. Record contributing factors, equipment and PPE used, surface and environment conditions, manual handling actions, and preventive measures. Close the loop with corrective actions using the hierarchy of controls (elimination, substitution, engineering, administration, PPE), assign owners and due dates, and track recommendations to completion. Ideal for WHS compliance across industrial and field environments.
With SafetyCulture you can
Digitize team workflows
Turn your workflows into digital templates or checklists so your team can conduct inspections efficiently and access them from any device.
Reduce manual errors
Help your team complete tasks more accurately with digital templates that minimize errors from manual processes.
Create and share inspection reports
Generate inspection reports and share them with your team and stakeholders to keep everyone informed.
About author
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.
