General Staff Incident Report Template

Use this incident report template to document workplace accidents, incidents, near misses, and equipment damage involving staff. Capture employee and employment details, date and time, hours at work, accident type, treatment, and nature of injury. Record location, how the event happened, training status, vehicles or significant hazards involved, and hazard register references. Assess severity, determine fitness for duties, note support needs and transport assistance, and create a corrective action plan with assigned responsibilities. Includes completion sign offs for worker, health and safety manager, management, and treating doctor. Suitable as a starting point and should be adapted to your policies and regulations.