This accident investigation report template helps teams systematically document workplace incidents and injuries. It captures incident time and location across areas like shipping/receiving, press room, finishing, maintenance, QA, and more. Record injury types (abrasion, laceration, trauma, slip, trip, fall, contusion), witness details, and a reverse-chronology accident sequence. Evaluate PPE requirements and usage, training adequacy, guarding and lockout needs, and any procedures followed. The questionnaire supports ergonomics, lifting, equipment condition, ladder use, and safety mechanisms. Conclude with root cause analysis, required corrective actions, photo evidence, drawings, and required signatures from employees, supervisors, managers, and safety leads.
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