NIKKIS OSHBOX Incident Investigation Form

This incident investigation form guides managers and health and safety representatives through documenting an incident from start to finish. Capture incident date, location, conditions, sequence of events, photos, and nature of injury. Record injured person details, treatment, and whether testing occurred. Identify immediate and underlying causes across location, equipment, procedures, people, hazard identification and controls, training, competence, supervision, governance, and standards such as PPE. Include witness details, medical treatment, and prevention steps with owners and due dates. Track notification to WorkSafe, investigation timestamps, and risk register updates. Close the investigation only after due diligence and full implementation of corrective actions by an Officer or PCBU.