Template

Incident Checklist

by Kim Piavanini, from the Community

10+

This incident checklist guides teams through securing the scene, protecting people, notifying the superintendent, preserving evidence, and documenting notifiable events. It covers scene management, communication methods (text, email, phone), photography, statements, fatigue assessment, and collection of permits and risk assessments (Take 5, JHA, multi-work permits). Built for mining operations, it supports compliant, consistent incident reporting and safer work practices.

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

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
Incident Checklist for Retail and Hospitality
Use this incident checklist to manage workplace incidents from start to finish. Secure and preserve the scene, assess risks, and prioritize the safety of people. Record key details including date, time, location, people and equipment involved, and environmental conditions. Notify the store manager or owner via phone, text, or email, and document the time and method of reporting. Gather evidence with photos, collect witness and participant statements, and conduct drug and alcohol testing where required. Complete a risk assessment and log the incident in the issue register to support accurate reporting and follow-up actions.
by Kim Piavanini, from the Community
Downloads: 0
Get
Template
Mining Incident Report Template
This mining incident report template helps teams document any event on site with consistency. Capture incident type, date and time, location, people involved, and photos of the scene. Record injuries, witness statements, and key details, then track post-incident actions such as police and doctor reports, PEP kit issuance, legal counsel, IT and security reviews, and notifications to HSE, management, and support services. Plan follow-up and remedial actions, including security updates and coordination with authorities, to strengthen safety and compliance across operations.
by rupert burton, from the Community
Downloads: 20+
Get
Template
ESV Incident Investigation (Updated)
This updated ESV Incident Investigation checklist supports investigations of gas or electrical events. Record incident date, time, location, site contacts, and notifications (police, fire, WorkSafe). Log ESV attendance and required resources. Capture appliance and vehicle details, gas readings, meters, serials, and registration numbers. Document onsite personnel, witness details, and a summary of the event and scene. Follow the investigation checklist: preserve the scene, identify breaches, collect and label exhibits, take readings, sketch and photograph the scene. Classify form of energy (gas, electricity) and incident type (e.g., electric shock, explosion, fire). Complete post-event actions: CIMS/PEGA entry, create files, obtain statements, compile BOE and FIR, submit for review, and upload to IMS.
by Lachlan Coulson, from the Community
Downloads: 0
Get
Template
Rural Fire Sitrep and Incident Details Template
This rural fire sitrep and incident details template helps crews capture critical information during wildfire or bushfire response. Record incident number and title, arrival time, location and grid reference, fire conditions and type, scrub and tree type, direction of travel, impacts, and estimates of area affected in hectares. Log resource needs, alarm level, appliances and tankers on scene, and initial and post-incident actions. Document incident command, talk group, out-of-area status, scene images, and handover details to ensure clear communication and consistent reporting.
by Richard Boscence, from the Community
Downloads: 20+
Get

Incident Checklist for Retail and Hospitality

Use this incident checklist to manage workplace incidents from start to finish. Secure and preserve the scene, assess risks, and prioritize the safety of people. Record key details including date, time, location, people and equipment involved, and environmental conditions. Notify the store manager or owner via phone, text, or email, and document the time and method of reporting. Gather evidence with photos, collect witness and participant statements, and conduct drug and alcohol testing where required. Complete a risk assessment and log the incident in the issue register to support accurate reporting and follow-up actions.

by Kim Piavanini, from the Community

Get

Template

Mining Incident Report Template

This mining incident report template helps teams document any event on site with consistency. Capture incident type, date and time, location, people involved, and photos of the scene. Record injuries, witness statements, and key details, then track post-incident actions such as police and doctor reports, PEP kit issuance, legal counsel, IT and security reviews, and notifications to HSE, management, and support services. Plan follow-up and remedial actions, including security updates and coordination with authorities, to strengthen safety and compliance across operations.

by rupert burton, from the Community

20+

Get

Template

ESV Incident Investigation (Updated)

This updated ESV Incident Investigation checklist supports investigations of gas or electrical events. Record incident date, time, location, site contacts, and notifications (police, fire, WorkSafe). Log ESV attendance and required resources. Capture appliance and vehicle details, gas readings, meters, serials, and registration numbers. Document onsite personnel, witness details, and a summary of the event and scene. Follow the investigation checklist: preserve the scene, identify breaches, collect and label exhibits, take readings, sketch and photograph the scene. Classify form of energy (gas, electricity) and incident type (e.g., electric shock, explosion, fire). Complete post-event actions: CIMS/PEGA entry, create files, obtain statements, compile BOE and FIR, submit for review, and upload to IMS.

by Lachlan Coulson, from the Community

Get

Template

Rural Fire Sitrep and Incident Details Template

This rural fire sitrep and incident details template helps crews capture critical information during wildfire or bushfire response. Record incident number and title, arrival time, location and grid reference, fire conditions and type, scrub and tree type, direction of travel, impacts, and estimates of area affected in hectares. Log resource needs, alarm level, appliances and tankers on scene, and initial and post-incident actions. Document incident command, talk group, out-of-area status, scene images, and handover details to ensure clear communication and consistent reporting.

by Richard Boscence, from the Community

20+

Get

Incident Checklist

About author

You might also like

Incident Checklist for Retail and Hospitality

Mining Incident Report Template

ESV Incident Investigation (Updated)

Rural Fire Sitrep and Incident Details Template

You might also like

Incident Checklist for Retail and Hospitality

Mining Incident Report Template

ESV Incident Investigation (Updated)

Rural Fire Sitrep and Incident Details Template