Accident Investigation

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How do you write an investigation report on an accident that just happened? What are examples of Accident Investigation reports? An easy way to start completing your document is to download this Accident Investigation template now!

This Accident Investigation report template is created after an incident happens, which means when something that happens, possibly as a result of something else, has to be reported, because it did damage. A commonly used incident, is for example of an incident is noticing an airplane in the sky, while taking a walk (a particular occurrence, especially one of minor importance to the person). However, the incident (accident) that this report type is referring to, has more to do with a violation of the law, for example the incident where someone is going to jail after being arrested for shoplifting. Something incident to something else. This sample Accident Incident Report template can help you find inspiration and motivation. This Accident Investigation Form Report covers the most important topics that you are looking for and will help you to structure and communicate in a professional manner with those involved. 

Accident Investigation Report REF: Number Notification of Accident at work In the event of an Accident, please complete the following: Site: Date of Accident: Department: About the person involved in the accident: Name: Address: Male: Female: Date of birth: Occupation: Home Telephone Number: Length of Service: Operation: Site Name: Address: Time of Accident: (Please use 24 hr format) Shift Pattern: Location of accident: (if off site please include address) Warehouse Yard Delivery Point Office Pick up point Other (Please Specify) Job Description at time of accident: Store delivery/Collection Garment processing Pack/repack Other (Please Specify) FLT driving Unloading Loading Order Picking Environmental Conditions: Dark Light Poorly Lit Direct Sunlight Dry Wet Slippery Windy Noisy Quiet Other: Hot Warm Humid Cold S: Health Safety Accident Investigation AIR – AI-001.doc Version 1.4 (July 2008) Even Floor Uneven Different levels Foggy Page 1 of 12 Accident Investigation Report Accident Causation: Lifting Operation of equipment without authorisation/training Faulty equipment Slips Trips Falls Personal Attack Not wearing PPE Cutting corners Pulling Falls from height Falling stock/equipment Equipment failure Horseplay Impact injury Other (Please specify) Parts of the body Affected: Abdomen Ankle Left Right Arm Left Right Back Chest Elbow Eye Foot Face Finger(s) Groin Hand Head Knee Leg Neck Left Left Left Right Right Right Left H Right H Left Right Left Left Right Right Left H Left Left Right H Right Right Shoulder Thumb Thigh Wrist Removal of safety guards Pushing First Aid Was first aid administered Yes Name of first aider: Were first aid facilities adequate If not give reason why No Did you know the location of the first aider Yes No Did you know the location of the first aid box Yes No Was hospital treatment necessary Yes No Accident Book Did you know the location of the accident book Yes No Has all the information required been entered into the accident book Yes No H

Instead, we provide this Accident Investigation Form template with text and formatting as a starting point to help professionalize the way you are working. Feel free to download this intuitive report template that is available in several kinds of formats, or try any other of our basic or advanced templates, forms or documents. Don't reinvent the wheel if an accident/incident happens for the first time, that is worth recording. Make sure the information is logged well in the report, so it can be a point of reference in the future if needed. Using this document template guarantees you will save time, cost and effort! It comes in Microsoft Office format, is ready to be tailored to your personal needs.

Download this Accident/Incident Report Form template and save yourself time and effort! You will see completing and submitting your incident form just became a little easier.


DISCLAIMER
Nothing on this site shall be considered legal advice and no attorney-client relationship is established.


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