Incident Report Form

Incident Report Form

This incident report form:

  • Can assist your business comply with aspects of AS/NZS ISO 45001, Management Systems clause 10.2. Incident, Non-Conformity and Corrective Actions.
  • Outlines the investigation process to determine how an incident occurred, the identification of contributing factors and what actions can be taken to prevent similar incidents in the future.
  • Can be completed for any accident, near miss or incident involving a worker or member of the public.
$5.90 - Includes 10% Tax

What is Incident Management?

Incident Report Form

Incident management is the process an organization uses to deal with unplanned events or incidents in the workplace. Incident management is important for several reasons. First, it helps ensure the safety of employees and others who may be affected by an incident. Second, it helps minimize the impact of an incident on the organization’s operations. And third, it helps the organization learn from incidents and improve safety compliance in the future.

The management of incidents includes immediate actions, notification, reporting, recording, investigation and corrective action associated with health, safety, environmental, operational, security and information technology incidents.

Management actions taken in response to an incident are to initially protect and minimize the impact on persons, environment, facilities, production and the community and the corrective actions implemented following an incident shall eliminate or reduce the likelihood of a reoccurrence.

What is an Incident Report Form?

An incident report form is used to document incidents that occur in the workplace. This form is used to report information such as the date, time, and location of the incident, as well as the name of the individual(s) who was involved.

This form is used to document the details of the incident, such as what happened and what was the injury or damage done. Completion of the form can help employers investigate incidents and determine what corrective action needs to be taken.

How to Fill Out Incident Report Form

Every incident should be investigated to determine exactly what led to the incident, how it occurred and the identification of all contributing factors. It is important to determine what action can be taken to prevent similar incidents in the future.

A person or team should be nominated with the responsibility of undertaking an investigation and completing the incident form. This person or team must be selected based on their training, experience and their knowledge of the workplace and work practice.

Safety-related incidents must be investigated using a thorough investigation methodology, to ensure all contributing factors and the root causes are identified.

Witness statements and interviews are to be taken as soon as possible following an incident unless this is not possible due to a serious condition. Corrective and preventative actions must be established based on investigation findings and are to be actioned as soon as reasonably practicable to prevent a recurrence.

What Benefits Does an Incident Report Form Provide?

Conducting an incident investigation and completing an incident report can be very beneficial for a business. It can help the organization identify incident causes and correct them before they cause any further issues. It can also help to improve communication and coordination within the organization.

The emphasis of the incident reporting process should be to protect and minimize the impact on persons, environment, facilities, production and the community. The corrective actions implemented should be focused on the elimination or reducing the likelihood of a reoccurrence.

Contents of this Incident Report Form

This incident report template has provisions for:

  • Details of the injury or illness of the affected person.
  • Incident type and description.
  • Immediate containment action.
  • Details of incident or near miss.
  • Property damage.
  • Treatment administered.
  • Did the worker stop work.
  • Incident investigation.
  • Preventative measures.
  • Actions completed.
  • Management review comments.
  • Notification information.
  • Name, signature and date.
  • Risk severity.

Note: The incident report has many subsections of the above information prompts too.

Why Choose to Buy this Incident Report Form?

  • This 3-page incident report form can be completed for any accident, near miss or incident involving a worker or member of the public.
  • The report has provisions for all the details that would need to be recorded for any workplace type of incident.
  • This very well-designed incident report can also help a business identify systemic problems and learn from mistakes.

After purchasing this form you will be able to:

  • Very easily edit and customize the template to create your own incident report.
  • Apply your own style, format and brand to the incident report.
  • Use it in any industry or sector regardless of size or type of organization.

Availability and Use of this Incident Report Form

  • This incident report form is accessible to you right now by clicking the ‘Buy Now’ button.
  • The form will be delivered to you in fully editable Microsoft Word format for immediate and full use in your business.
  • There are no subscriptions, contracts or ongoing costs.

Incident Report Form Guarantee

This report form is 100% satisfaction guaranteed.

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