Worksite Incident / Injury Report Form

Every workplace should have a Worksite Incident / Injury Report Form available for employees and contractors to use to report an accident or mishap.

  • A report should be filled out whether or not the incident resulted in an injury. Recording near misses is crucial to developing good workplace safety policies.
  • A witness filling out the form must report whether there was an injury, what the extent of the injury was, and what treatment was administered onsite (if any).
  • The employer also completes part of the form with respect to time at work missed by the injured person, the results of the incident investigation, a risk assessment, and actions taken to prevent a recurrence.

Keep your employees aware of work-related safety issues, and make sure that everyone knows how to fill out and submit the Worksite Incident / Injury Report Form. Download a free copy for your workplace.

Document Type: Microsoft Word
Last Updated: 14-April-2016
SKU: 9152
$0.00
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Accident and Incident Reporting Policy

Set out your company's policy and procedure for reporting workplace accidents and incidents in this downloadable and customizable Policy Statement template.

  • The Policy must be followed by all employees, contractors and visitors to the company's premises and all who use company equipment or vehicles.
  • Procedures for reporting all accidents, incidents and injuries are described in detail.
  • Company management and safety officers will conduct an investigation, record the findings, make recommendations and take appropriate action to prevent a recurrence.
  • It's the responsibility of everyone to improve workplace safety. Make sure your workers understand what's required of them.
  • Available in MS Word format and fully editable.
$17.99