Template

Workplace Hazard Report Form

by Wendy Worters, from the Community

This workplace hazard report form helps teams identify and report serious hazards at any site. Capture hazard details and reported date, name the site and manager, assess risk using a simple risk matrix to determine initial risk, and outline control actions to eliminate or mitigate the hazard. Track whether controls are implemented, record residual risk after action, assign a responsible person with a due date, and capture manager and CEO signatures to confirm completion. Ideal for ongoing facility safety reporting and incident prevention across industries.

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
Podium Industries Hazard Report Form
Use this Hazard Report Form to capture and manage workplace hazards from identification through control. Record site and personnel details, describe the hazard and context, select hazard types such as manual tasks, machinery and equipment, hazardous chemicals, electricity, extreme temperature, noise, radiation, biological, or psychosocial. Assess risk by noting consequence and likelihood to generate a risk rating. Document immediate controls, add photos before and after, and outline long-term recommendations. Capture sign-offs from the person raising the hazard and collect supervisor or HSR comments, including follow-up actions and whether a formal risk assessment is recommended.
by Aaron Hancock, from the Community
Downloads: 0
Get
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
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
Downloads: 700+
Get
Template
Hazard Reporting Form with Risk Assessment
Capture and report hazards on site with a structured form that guides teams from identification to control. Record project and site details, describe the hazard and context, add photos, and assess risk by consequence, likelihood, and overall rating. Document immediate controls, take after-action photos, and note long term recommendations. Includes fields for worker sign off, supervisor comments, and whether a formal risk assessment is required. Ideal for construction and general workplace safety.
by Matt Crozier, from the Community
Downloads: 10+
Get

Workplace Hazard Report Form

About author

You might also like

Podium Industries Hazard Report Form

Incident and Hazard Report Form

Hazard Report Form

Hazard Reporting Form with Risk Assessment

You might also like

Podium Industries Hazard Report Form

Incident and Hazard Report Form

Hazard Report Form

Hazard Reporting Form with Risk Assessment