Template

Incident / Hazard Report Form

100+

Use this hazard report form to: - Identify the incident / hazard type and the level of treatment needed - Record who was injured, their contact number, and the nature of the injury - Document the task/s performed when the incident / injury occurred - Check which factors contributed to the hazard, incident, and/or injury - Specify the control type when creating corrective actions

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Digitize team workflows

Turn your workflows into digital templates or checklists so your team can conduct inspections efficiently and access them from any device.

Reduce manual errors

Help your team complete tasks more accurately with digital templates that minimize errors from manual processes.

Create and share inspection reports

Generate inspection reports and share them with your team and stakeholders to keep everyone informed.

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SafetyCulture

Free 1,000+ Workplace Checklists & Templates created by the SafetyCulture team.

Template
Incident and Hazard Report Form
Use this incident and hazard report form to document events and hazards in the workplace. Capture reporter details, location, incident or hazard type, and a clear description. Record injury information including injured person, contact, nature and location of injury, and treatment provided. Assess risk using consequence and likelihood to determine overall risk level. Identify contributing factors such as inadequate equipment, procedures, supervision, or training, and define corrective actions with control type, due dates, and assignees. Route the report to the right person and capture signatures to close out the report.
by Pooja Prasad, from the Community
Downloads: 0
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Template
Hazard Report Form
Use this hazard report form to: - Keep track of when and where the hazard was reported - Describe the hazard using text, images, and annotations - Determine the seriousness of the injury and the medical attention required - Create a corrective action plan to minimize hazard risk - Implement control measures for accident prevention
by SafetyCulture
Downloads: 700+
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Template
Platinum Accident Report V2
This Platinum Accident Report V2 template helps teams document workplace incidents in detail. Capture the date and time, injured person’s name and department, exact injury location on the body, and type of injury. Record a factual description of the incident as reported by the injured person, list witnesses, and note any first aid treatment provided. Track the injured person’s status after the event, including return to work or transfer to medical care. Attach photos of the injury and incident location, and confirm manager notification. The report emphasizes confidentiality and advises leaving the incident site undisturbed until properly reviewed.
by Tim Charlton, from the Community
Downloads: 0
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Template
Incident Injury Report Form Template
Use this Incident Injury Report Form to document workplace accidents and near misses. Record personal and incident details, witness information, injury type and body part affected, contributing factors, and site conditions. Includes an investigation checklist, risk controls (elimination, substitution, engineering, administration, PPE), and action tracking to prevent recurrence and improve WHS compliance.
by John Patrick Agustin, from the Community
Downloads: 10+
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Incident and Hazard Report Form

Use this incident and hazard report form to document events and hazards in the workplace. Capture reporter details, location, incident or hazard type, and a clear description. Record injury information including injured person, contact, nature and location of injury, and treatment provided. Assess risk using consequence and likelihood to determine overall risk level. Identify contributing factors such as inadequate equipment, procedures, supervision, or training, and define corrective actions with control type, due dates, and assignees. Route the report to the right person and capture signatures to close out the report.

by Pooja Prasad, from the Community

Get

Template

Hazard Report Form

Use this hazard report form to: - Keep track of when and where the hazard was reported - Describe the hazard using text, images, and annotations - Determine the seriousness of the injury and the medical attention required - Create a corrective action plan to minimize hazard risk - Implement control measures for accident prevention

by SafetyCulture

700+

Get

Template

Platinum Accident Report V2

This Platinum Accident Report V2 template helps teams document workplace incidents in detail. Capture the date and time, injured person’s name and department, exact injury location on the body, and type of injury. Record a factual description of the incident as reported by the injured person, list witnesses, and note any first aid treatment provided. Track the injured person’s status after the event, including return to work or transfer to medical care. Attach photos of the injury and incident location, and confirm manager notification. The report emphasizes confidentiality and advises leaving the incident site undisturbed until properly reviewed.

by Tim Charlton, from the Community

Get

Template

Incident Injury Report Form Template

Use this Incident Injury Report Form to document workplace accidents and near misses. Record personal and incident details, witness information, injury type and body part affected, contributing factors, and site conditions. Includes an investigation checklist, risk controls (elimination, substitution, engineering, administration, PPE), and action tracking to prevent recurrence and improve WHS compliance.

by John Patrick Agustin, from the Community

10+

Get

Incident / Hazard Report Form

With SafetyCulture you can

Digitize team workflows

Reduce manual errors

Create and share inspection reports

About author

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Incident and Hazard Report Form

Hazard Report Form

Platinum Accident Report V2

Incident Injury Report Form Template

You might also like

Incident and Hazard Report Form

Hazard Report Form

Platinum Accident Report V2

Incident Injury Report Form Template