Incident Report Sample Forms and Templates

Incident Report Sample - Incidents are bound to happen. Apart from taking precautionary measures to lessen the risks of incidents, it's also crucial to act as quickly as possible if an incident occurs. Creating an incident report sample template is important in meeting this goal.

Let's take a closer look at what an incident report template sample looks like and the important factors you should not forget. Read on.

What Is An Incident Report?

Incidents can have a far-reaching effect on productivity, which is why it's essential to have them properly documented. Creating an incident report is the first step in doing so.

An incident report is a document that provides the details of an incident—as accurate as possible. It is especially crucial when damages, injury, or death are incurred. It can help your business take into account the different events that lead to such an incident and the aftermath of this occurrence.

In addition to an accident or injury, a simple incident report example form may also include near misses or other unusual or hazardous happenings in different contexts.

Incident Report Inclusions

The following essential features define an incident report sample forms and templates:

  1. Detailed description
  2. The circumstances enclosing the incident
  3. Date, time, and location
  4. The details on witnesses and victims
  5. Reactionary measures put in place
  6. The aftermath
  7. Corrective actions to take to minimize the likelihood of another incident
Incident Report Sample

Types of Incident Report Sample

There are different types of incidents, which you can use to report an incident on the worksite. It includes:

Injury and Lost Time Incident Report Sample

Injuries that involve medical treatment, lost time, or altered responsibilities need to be recorded as soon as possible. Some of the most important elements to include are:

  • Type of incident (injury/near miss/property damage/theft)
  • Location (address)
  • Date and time of the incident
  • Name
  • Name of supervisor
  • Description of the incident, particularly the specific job site location, sequence, and the results of events
  • Whether or not staff wore PPE
  • The root cause(s) of the incident
  • Correlated hazards ]raised and resolved after the incident
  • The victim's version of the events
  • Actions taken
  • Description of injuries
  • Whether emergency services were called or not
  • Treatment required
  • Names of witness(s) and their statements
  • Photographs of the scene

The list may seem a lot, but including them in the report helps you better understand the whole occurrence. That's why it's important to recall and document the above information in as detailed and concise a manner as possible. Lapses in your report could lead to misguidance and missed opportunities to learn from the mistake and create a safer workplace.

The incident report sample template must describe the event in a narrative format so you can review it with greater clarity. When the document is completed and ready, you may proceed with any legal reporting requirements. You may want to keep the files and store them for the duration of your employment.

Exposure Incident Report Sample

Working in environments with dangerous chemicals or pathogens calls for strong safety measures. If an incident occurs, it's important to record the event carefully in a detailed incident report sample form. You must include the following details:

  • Type of incident (injury/near miss/property damage/theft)
  • Address
  • Date and time of the incident
  • Name
  • Name of supervisor
  • Description of the incident, particularly the specific job site location, sequence, and the results of events
Incident Report Example
  • Name of the chemical/pathogen/carcinogen, their amount, concentration, and description of hazard labels or safety data sheets
  • Exposure monitoring data
  • Whether or not a contaminated sharp was present
  • Whether or not the staff wore PPE
  • The root cause(s) of the incident
  • Correlated hazards ]raised and resolved after the incident
  • The victim's version of the events
  • Actions taken
  • Description of injuries, specifically the body part(s) exposed, length of exposure, and size of area exposed.
  • Signs and symptoms displayed
  • Whether emergency services were called or not
  • Treatment required
  • Names of witness(s) and their statements
  • Photographs of the scene

It's also important to include medical reports and lost time from work. Keep the document on hand for the duration of the employee's stay with the company, at a minimum.

First Aid Incident Report Template Sample

On the other hand, workplace incidents may call for on-site or walk-in medical first aid treatment. These occurrences don't usually require an employee incident report, but it's still important to properly document the vent.

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Finding the Right Incident Report Example

Incident reports are important to creating a proactive, fact-based safety strategy that leads to a safer work environment. If you're looking for a solution that can help you build an incident report example form tailored to your industry, a product with free incident report sample templates would be a great choice. Check out FormBot today and see how we can help.

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