Template

KI 9365 Accident Report Form

by Mihaly Vantara, from the Community

Use this KI 9365 Accident Report Form to document workplace incidents and injuries on-site or in the field. Capture who was injured, when and where the event occurred, body parts affected, photos, tools or equipment involved, and contributing factors. Collect witness statements, note medical or police involvement, and identify root cause. Add corrective and preventive actions, then sign off with injured person and supervisor to help prevent recurrence.

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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 Report Form for C&M Staff
This accident report form helps C&M staff record workplace incidents involving employees or other persons on site or in the field. Capture injured person details, date, time, and exact location, describe the injury and how it occurred, note equipment or tools in use, and document contributing factors and safety control failures. Collect witness details and statements, track any medical attention or police involvement, and define corrective and preventive actions. Obtain sign-offs to confirm follow-up and communication with operations leadership.
by Chris Lewis, from the Community
Downloads: 0
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Template
Off-Site Accident Report Form
This off-site accident report form helps teams capture complete details of workplace incidents in the field, including injured person information, time and location, incident descriptions, photos, equipment and PPE in use, and contributing causes. Record witness statements, emergency response, and medical or police involvement. Attach RAMS and supporting evidence, note notifications to site, line manager, HSE and HR, and finalize with signatures for accurate, compliant reporting.
by Andy Pryer, from the Community
Downloads: 10+
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Template
Accident Report Form for C and M Staff
This accident report form helps C and M staff document workplace injuries and incidents from initial details to final sign off. Capture injured person information, date and location, injury nature, equipment involved, and contributing factors. Record witness statements and contacts, note medical attention and police details, and outline corrective actions to stop recurrence. Includes signatures for accountability.
by Chris Lewis, from the Community
Downloads: 0
Get
Template
Trip Hazard and Fencing Inspection KI 9365
This KI 9365 template helps inspectors survey public walkways and fencing for trip hazards and damage across multiple locations. Record findings, add notes, and list items requiring maintenance. Capture signatures, document actions, and standardize routine safety audits for estates, parks, and communal areas.
by Mihaly Vantara, from the Community
Downloads: 0
Get

Accident Report Form for C&M Staff

This accident report form helps C&M staff record workplace incidents involving employees or other persons on site or in the field. Capture injured person details, date, time, and exact location, describe the injury and how it occurred, note equipment or tools in use, and document contributing factors and safety control failures. Collect witness details and statements, track any medical attention or police involvement, and define corrective and preventive actions. Obtain sign-offs to confirm follow-up and communication with operations leadership.

by Chris Lewis, from the Community

Get

Template

Off-Site Accident Report Form

This off-site accident report form helps teams capture complete details of workplace incidents in the field, including injured person information, time and location, incident descriptions, photos, equipment and PPE in use, and contributing causes. Record witness statements, emergency response, and medical or police involvement. Attach RAMS and supporting evidence, note notifications to site, line manager, HSE and HR, and finalize with signatures for accurate, compliant reporting.

by Andy Pryer, from the Community

10+

Get

Template

Accident Report Form for C and M Staff

This accident report form helps C and M staff document workplace injuries and incidents from initial details to final sign off. Capture injured person information, date and location, injury nature, equipment involved, and contributing factors. Record witness statements and contacts, note medical attention and police details, and outline corrective actions to stop recurrence. Includes signatures for accountability.

by Chris Lewis, from the Community

Get

Template

Trip Hazard and Fencing Inspection KI 9365

This KI 9365 template helps inspectors survey public walkways and fencing for trip hazards and damage across multiple locations. Record findings, add notes, and list items requiring maintenance. Capture signatures, document actions, and standardize routine safety audits for estates, parks, and communal areas.

by Mihaly Vantara, from the Community

Get

KI 9365 Accident Report Form

About author

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Accident Report Form for C&M Staff

Off-Site Accident Report Form

Accident Report Form for C and M Staff

Trip Hazard and Fencing Inspection KI 9365

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Accident Report Form for C&M Staff

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Trip Hazard and Fencing Inspection KI 9365