Accident Incident Report Form
Accident Incident Report Form
Accident Incident Report Form
It’s imperative to institute a systematic method for investigating accidents. A report needs to include
all the essential information about the accident or near-miss. The process begins with fact finding and
ends with recommendations for preventing costly future workplace accidents. Writing any incident
report involves four basic steps.
1. Respond Immediately - Employees should notify their supervisor as soon as an accident or injury
occurs. The supervisor’s first responsibility is to see that proper medical treatment or first aid is
provided. Also, if the hazard still exists, the supervisor needs to immediately eliminate it. Your
company should have an established procedure for this.
2. Find the Facts - Once the immediate response has been completed; a thorough on-site accident
investigation should be conducted by an investigation team. This should take place quickly after the
incident so those affected still have the situation fresh in their mind. Items to review include:
3. Analyze - After determining how, you must find out why. This is necessary for developing an
effective plan of action for control. Causes include:
Primary causes (e.g. a spill on the floor that caused a slip and fall)
Secondary causes (e.g. employee not wearing appropriate work shoes or carrying a stack of
material that blocked vision)
Other contributing factors (e.g., burned out light bulb in the area)
4. Complete Corrective Action Plan - Recommendations for corrective action might include
immediate corrective action, as well as long-term corrective actions such as: