Template

Cromwell Incident and Investigation Report Form

by Rod Martin, from the Community

10+

This Cromwell Incident and Investigation Report Form helps teams record workplace incidents from initial details through closeout. Capture person and incident information, injuries and affected body parts, mechanism of injury, and work location. Document witnesses, treatment provided, photos or CCTV, and potential workers’ compensation. Assess risk using a matrix, analyze contributing factors across unsafe acts, conditions, and system deficiencies, and document root causes. Assign and track corrective actions, then rate residual risk. Include approvals and signatures to formally complete the investigation.

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
Motor Mall Incident Report Full Investigation
Use this incident investigation report template to document incidents from first notification through root cause. Record incident details, timelines, environmental conditions, evidence and attachments, vehicle and equipment logs, damages, and people involved. Capture statements, injury types and body parts affected, and medical treatment. Perform root cause analysis, note contributing factors, and add corrective actions. Finish with sign off and follow up to close out the investigation.
by Liam Daniels, from the Community
Downloads: 0
Get
Template
Incident Investigation Report Template
This comprehensive incident investigation report template helps teams capture the facts, evidence, and outcomes of workplace incidents from start to finish. Record incident details and timelines, document weather conditions, log evidence with photos, and track vehicles, equipment, damages, and other items. Capture people involved, witness statements and signatures, and detailed injury information including type and affected body parts. Conduct a structured root cause analysis using contributing factors and five whys to identify underlying causes and likelihood of recurrence. Plan and verify corrective actions and recommendations, then finalize with investigator and reviewer sign-offs and follow-up assignments. Ideal for construction and field operations seeking a thorough, repeatable approach to incident documentation and prevention.
by Mark Baylis, from the Community
Downloads: 10+
Get
Template
Incident and Accident Investigation Template
This incident and accident investigation template helps teams document workplace incidents thoroughly. Capture investigation details, incident type, injured person information, date and time, and affected body parts. Record tasks being performed, training status, a detailed narrative of events, images, and all witnesses. Track medical treatment and outcomes, including first aid provided and follow-up care. Gather signed witness statements. Identify causes and contributing factors such as machine or electrical faults, PPE use, training, and housekeeping. Plan immediate corrective actions and longer term preventive measures, assign ownership and timelines, and note reportability and time off. Conclude with results, damaged equipment, and authorizations.
by Ed Coleman, from the Community
Downloads: 10+
Get
Template
Full Incident Investigation and Report
This incident investigation template helps teams collect evidence, document incident details, and perform root-cause analysis for hazards, near-misses, accidents, injuries, and property damage. It includes sections for timelines, weather conditions, evidence and attachments, vehicle and equipment logs, damage records, people involved and statements, injury classifications and affected body parts, corrective actions, and sign-off. Use it to create a thorough, compliant investigation report that goes beyond an initial incident report and supports prevention and follow-up.
by Craig Lee, from the Community
Downloads: 10+
Get

Cromwell Incident and Investigation Report Form

About author

You might also like

Motor Mall Incident Report Full Investigation

Incident Investigation Report Template

Incident and Accident Investigation Template

Full Incident Investigation and Report

You might also like

Motor Mall Incident Report Full Investigation

Incident Investigation Report Template

Incident and Accident Investigation Template

Full Incident Investigation and Report