Template

Injury, Accident and Incident Report Template

by Vladislav Petrov, from the Community

10+

This incident report template helps retail centers and facilities teams document injuries, near misses, security events, property damage, and environmental incidents in one structured form. Capture personal details, incident type, environmental and lighting conditions, witness statements, injury descriptions, first aid provided, and emergency services involvement including police, ambulance, or fire brigade. Record equipment or machinery involved, CCTV references, and corrective actions with responsible persons. Designed for security, housekeeping, guest services, maintenance, and management to ensure consistent reporting and support investigations and prevention.

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
Injury, Accident, Incident and Damage Report
This incident report template helps teams capture comprehensive details for injuries, accidents, near misses, and property damage on-site. Record the incident time, location, people involved, and who it was reported to. Add witness details and statements, first aid or medical treatment, and photos of damage and environmental conditions. Document immediate causes, contributing factors, and corrective actions with responsible persons. Assess potential severity and likelihood of recurrence, include comments, and finalize with approvals and signatures to close out the report. Ideal for construction and field operations to standardize reporting and improve safety.
by Conview Team 2, from the Community
Downloads: 0
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Template
Injury, Accident, and Incident Report (Demo)
This free demo incident report template helps document workplace injuries, accidents, and near misses. Capture incident details, date and time, location, people involved, and witness statements. Record injury specifics, property or vehicle damage, photos, and environmental conditions. Analyze direct and underlying causes, assess potential severity and recurrence, and assign corrective actions with responsible persons and due dates. Includes signature fields for verification.
by Ashley Herrera, from the Community
Downloads: 10+
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Template
Injury, Accident, and Incident Report
This digital incident report template helps teams document workplace injuries, accidents, and near-misses thoroughly. Capture incident details, location, witnesses, first aid or medical treatment, and property or vehicle damage. Record environmental conditions, immediate causes, and contributing factors, then assign corrective actions with responsible persons and due dates. Assess potential severity and likelihood of recurrence, attach photos, and sign off to support safety investigations and regulatory compliance across transport and logistics operations.
by Everette Borg, from the Community
Downloads: 10+
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Template
Injury, Accident, Incident and Near Miss Report
Use this comprehensive incident reporting template to capture key details after any workplace injury, accident, incident, or near miss. Record staff involved, date, time, location, witnesses, and notifications. Document injuries and treatment, police involvement and tests, property or vehicle damage, and attach photos. Analyze immediate causes and contributing factors, assess potential severity and likelihood of recurrence, and define corrective actions with responsible persons. Include third party details and insurance information to support follow up and compliance.
by Warren Ellison, from the Community
Downloads: 0
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Injury, Accident and Incident Report Template

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Injury, Accident, Incident and Damage Report

Injury, Accident, and Incident Report (Demo)