Workplace Incident Report Template

Who Should You Report a Workplace Accident To?

All Workplace Accident Report Forms should be completed and handed over to the manager responsible for such events. If the injury is not too serious, the problem can be resolved on a manager-employee basis. However, there is a set procedure for any serious accidents or injuries that occur concerning employees which would need to be reported to the Occupational Safety and Health Administration department.

If the accident occurs to a customer, the issue should be brought up with management to ensure that the organization does not ignore the problem. Businesses will usually have a set procedure in place for dealing with such accidents in an appropriate way to ensure an optimal result is achieved for all parties. The manager would be able to provide more detailed information on this topic.

Workplace Accident Report Form: How to Make?

In order to create a Workplace Accident Report, there are several things you need to include. Without this, you may miss some key details which could prove crucial. We have compiled a list of all the things that ought to be included in a general Workplace Accident Report Form which can be found below:

• Details of the store name along with full address of where the accident had occurred;
• The date that the report was drafted;
• General information concerning the accident . This should include the date and time of the incident and a brief but detailed description of the incident itself;
• Provide information regarding the store manager at the time of the accident;
• Name the member of staff that has filled in the report form . If this individual witnessed the accident, they should provide confirmation of this;
• Note down the weather conditions at the time of the incident;
• If any piece of equipment was affected during the accident, this should be detailed in a separate section and this product needs to be taken to be further analyzed;
• Next, the location of the incident should be described along with information of the inspection that followed as a result of the accident . This would concern whether or not the inspection was instant, photographs of the location along with details concerning signs, cleanliness and lighting;
• The next part should clearly detail the name and personal contact information of the individual that was injured . This would also include their occupation and the clothes they were wearing as well as a description of the obtained injury;
• If any medical treatment was offered or performed, this also needs to clearly be written out;
• Finally, if any witnesses were present during the accident then their contact details should be recorded for potential further communication.

Haven't found the template you're looking for? Take a look at the related templates below:

• Warehouse Incident Report Form;
• Employee Incident Report Form;
• Customer Incident Report Form.