Template

QMF028 Accident and Incident Investigation Form

by SMS Shoalbuster, from the Community

10+

QMF028 is a comprehensive accident and incident investigation form designed to standardize reporting and corrective actions. Capture casualty details, time and location, plant or machinery involved, and hazardous substances. Review risk assessments (manual handling, COSHH, PPE, fire), document control measures, witness statements, contractor involvement, supervision, and equipment use. Note workplace conditions, list deficiencies, add comments and photos, and finalize with investigator details.

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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
Accident and Incident Investigation Form
This accident and incident investigation form helps teams document workplace events thoroughly. Capture incident details, exact location, date and time, witness statements, photos, and CCTV availability. Record injuries, first aid provided, hospital admission, work time loss, authorization, experience, and behaviors. Review risk assessments, safe procedures, environmental factors, safety devices, equipment or hazardous substances involved, training, and supervision. Identify immediate, underlying, management, technical, and root causes. Define remedial actions, track implementation, and complete manager sign off. Includes data protection notice.
by Agnes Borbely, from the Community
Downloads: 0
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Template
Accident/Incident Investigation Template
Use this construction accident/incident investigation template to document workplace events thoroughly. Record incident details, date and time, location, weather, people involved, first aid, and emergency response. Capture plant and equipment involved, witness statements, and training qualifications. Identify contributing causes, immediate corrective actions, and long-term lessons learned. Conclude with findings and responsibility to improve site safety and compliance.
by Steve Nicholson, from the Community
Downloads: 10+
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Template
Accident Investigation Checklist
This accident investigation checklist helps teams document incidents thoroughly and consistently. Capture key details such as the investigation number, investigator, date, injured person, and immediate actions taken. Record site conditions with photos, precise location, equipment or vehicles involved, and CCTV availability. List documents to collect including risk assessments, training records, maintenance logs, COSHH assessments, manual handling assessments, and previous incident reports. Gather physical evidence like damaged parts, PPE, and relevant articles or substances. Use the checklist to build a clear picture of what happened, analyze root causes, and assign corrective actions to improve workplace safety and compliance.
by Mark Smith, from the Community
Downloads: 10+
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Template
Accident Investigation Form
This accident investigation form helps construction teams document workplace incidents thoroughly and consistently. Record incident details, location, date and time, weather conditions, and photos. Capture involved employee information, witness details, and training status. Verify JHA availability and compliance, note pre-task checklist completion, and identify causes, contributing factors, and any safety violations. Summarize findings and assign corrective actions with responsible persons, due dates, and signatures. Designed to support root cause analysis and continuous improvement across job sites.
by Joe Schemonia, from the Community
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QMF028 Accident and Incident Investigation Form

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