2022

Incident Report Template

Workplaces tend to have numerous incidents and it is always good to be prepared for such an accident. 

Wondering how to pen down an incident report for human resources or management? Don’t worry, you are at the right place.

What is an Incident Report? 

An incident report is a document for all workplace injuries, illnesses, near misses, and accidents. An incident form should be completed when an incident occurs, no matter how minor the damage is.

Any injury or illness that impacts an employee’s health or ability to work must be taken into account. In addition, the details of what is required in an incident report will differ depending on the provincial or federal legislation that affects your workplace. As a result, all incident reports will differ; for example, the incident report template will not be the same as the business department action incident report. 

Here is an example of one of the incident report forms:

Incident Report Template

What Should You Include in an Incident Report Form?

There are multiple incident reports, depending on your profession and industry. A majority of these include an employee incident report template. Most will consist of the underlying details listed below to understand what happened: 

  • The day, date, and time of the incident
  • The type of incident that took place
  • Where the incident happened
  • Injuries obtained
  • Names of the people involved 
  • Equipment involved
  • Medical treatment that may be required
  • Eyewitnesses who can tell their perspective
  • Events leading up to the incident 

How to Write an Incident Report

It is essential to lay out an incident report clearly and concisely with all the relevant information. The clearer it is, the easier it will be to understand the cause of the accident. 

The jargon for incident reporting should not be too personal or emotional and should not purposefully blame any individual.

Shown below is an incident report example template:

Introduction

This should include the what, who, when, and where of the employee incident: Who was involved. What happened. Where precisely in the workplace does it happen. For example, the floor leads to the third stairwell in the main building when it took place. Then include the time, day, date, and a summary of what happened.

Body

This must include all the details of the accident. It should not leave anything out and should be chronological.

Conclusion

This should state what happened with the incident, if it was resolved and what the results were.

Summary

The employee should conclude the report reiterating what happened again. The incident report should acknowledge that this is everything the employee remembers happening.

This workplace incident report template includes best practices and the basic guidelines to make sure the report consists of all the details it should. Once an account is written, it should be kept on record in the workplace. 

What to do after an incident happens?

1. Take Immediate Action 

Employees of your organization should notify a member of the company’s leadership committee or their manager as soon as an incident occurs, regardless of the nature of the event.

That being said, there need to be clear communication channels to encourage the practice of employees coming forth in such situations and the importance of these.

Once an incident has been noted, the manager’s first responsibility is to ensure appropriate treatment for those impacted due to the event.  

Additionally, if the hazard still exists, the manager that the event has been reported to must eliminate the risk by handling and controlling it. Each company should have an established procedure for accomplishing this based on the environment and nature of their work. Like, if there was a spill that caused a fall. By using a sign, you are attending to the victim and having the spill wiped up, and identifying the area as a hazard.

2. Collect the Facts 

Once the immediate action, including responding to the incident and removing the hazard from the surroundings, has been done, it is time to determine and record the facts related to the accident. 

Facts include:

Incident Facts

The Basics

Identify the exact date, time, and location of the incident. This information is necessary for the investigation and the most transparent information to collect. 

The Affected

Collect details of those involved and affected by the incident. This would entail recording the name of the individual(s) applied, their job title(s), and the department(s) they operate in as the managers of the people affected. 

The Witnesses

Speak to each and every witness of the event to collect their perspectives on the event. Record their statements as detailed and accurate as possible.  

To ensure accuracy, it is best to get your notes reviewed by the witness to make sure they validate your portrayal of how the event was on the report. Including the names of any witnesses in the report is essential in case extra questioning is needed. 

The Context

Consider and note the events that occurred leading up to the incident. 

Ask:

  • What was the employee doing? 
  • How was the employee feeling before the incident?
  • Who asked them to complete the task? 

It is essential to identify which factors were an outcome of the incident and which were present before the incident and could be a potential contributing factor to the accident.

The Actions

​​In the report, you must specify the actions of those involved during the incident. For example, what was the employee doing that led to the incident? 

For example, if an employee hurt their back while lifting a box at work, it is crucial to determine how that employee lifted the box to agree and decide if that aided in their injury.

If the answer is yes, then inquire if this employee was appropriately trained for this specific task and by what source and which person? 

The Environment

Record and identify environmental conditions that contributed to the event. Was there inadequate lighting? Was a piece of equipment not operating correctly? Did a blind spot obstruct the employee’s visibility?

The Injuries

Record elaborate descriptions of particular injuries and evaluate the severity of those in the document. This description should include parts of the body injured, nature, and extent of injuries.

The Treatment

It is also essential to document the treatment administered for the acknowledged injuries in the incident case report. This information is necessary to record how the employee recovers when reviewing the specifics of the event.

The Damages

Record and account for any damage to materials, equipment, etc., that was ruined by the incident. This will be helpful during the analysis of the event to determine what items will need to be repaired or replaced and consider a corrective action plan. 

3. Analyze and Reflect 

Recording and collecting facts related to the occurrence will help in determining how the incident occurred in the first place. Analyzing the combined points pertaining to the incident will help in determining the cause of the incident.

It is essential to analyze and determine the how and why of the incident to develop an effective corrective action plan. 

Potential causes for accidents or injuries that occurred in the workplace could include: 

  • Primary causes (for example, an ice patch on a set of stairs that caused a slip and fall). 
  • Secondary causes (like an employee not wearing appropriate personal protective equipment, such as a hard helmet or eyewear).
  • Other contributing causes (for example, a burned-out light bulb in the area causing poor visibility). 

Causes for Accidents

4. Establish a Corrective Action Plan 

A Corrective Action Plan would provide recommendations to reduce the possibility of a continued issue and recurrence of the incident details. 

The recommendations would result from analyzing a practical fact collected and documented in the incident report. 

Elements of an efficient Corrective Action Plan can include: 

  • Occupational Health & Safety training 
  • Conducting an analysis of a job hazard situation to determine if other potential hazards are associated with the environment and task and then training employees on these hazards based on the findings of the assessment 
  • Preventative processes like routine maintenance processes that ensure equipment is in proper working condition 
  • A review of job procedures and practices with a recommendation for changes to reduce the risk of incidents 
  • Engineering, equipment, or PPE upgrades to ensure the task or the process of completing said task poses less risk.

Incident Report Examples

Based on the type of workplace incident, the writer will need to include various pieces of information. 

If you are unsure how to write an incident statement, here are example incident reports for the workplace covering multiple scenarios. 

Injury Incident Report Templates

1)At 11.20 am on Tuesday 7th July 2020, a worker, [name], tripped over an electrical wire on the x construction site, located on [place]

He was carrying a heavy object at the time. 

It is believed the wire shouldn’t have been laid across the ground without any safety tape securing it as nothing was drawing attention to it. 

[Name] fell to the ground and dropped the hammer but did not injure himself. However, he twisted his ankle, which immediately began to swell, and scrapped the side of his leg in a minor way. A co-worker came to assist [name] to his feet and helped him walk to a nearby bench. [Name] could not put his weight on his left foot, so he was taken to a nearby hospital. 

Once at the hospital, doctors confirmed that [name] sprained his foot, more specifically his ankle, and should keep his foot upright and elevated and gain support by crutches for two weeks. It would be hard for him to work during this period. 

The construction site lead has assessed the wires on the ground and concluded that brightly colored tape should secure the cables to the floor to put attention to them and ensure that there are no problems in the wire that are easy to trip over so that this does not happen again.”

2) “On [day, date, year], [name] was walking along the corridor between buildings four and five of [place] when he observed that there was something sharp sticking through his right shoe. 

He stopped to observe what it was and found a nail stuck in his shoe. 

He took his shoe and was, fortunately, able to pull the nail out as it had not pierced through his foot and barely scraped it. He saw the stairwell was getting new handrails fitted and presumed the nail came from that. 

However, he saw two other nails further along the corridor and picked them up to ensure nobody else was vulnerable to them. He reported the incident to his manager’s office, where he showed the nails and explained the situation. His foot had a minor cut, so [name]‘s manager assisted him by providing an antiseptic wipe and a band-aid to help him. 

[Name] returned to work while his manager talked to the construction workers about keeping their workspace neat and preventing any further accidents like this from happening”. 

3) An appropriate incident form template example can be:

Employee Incident Report  

Reported by [Title/Role]

Date of Report:

Incident Number:

Date of Incident:  

Employee Name: 

Date of Type: 

Employee Role:   

Location: 

Street Address

City State ZIP Code

Specific Area of Location (if applicable):  

Incident Description (including any events leading to or immediately following the incident):

Name/Role/Contact of Parties Involved:

1.

2.

3.

Name/Role/Contact of Witnesses:

1.

2.

3.

Was a police report filed?

  • Yes
  • No

Employee Name

Reporting Staff Name

HR Rep. Name

Employee Signature

Reporting Staff Signature

Date

HR Rep. Signature

Date

Employee Explanation of Events:

Resulting Action Executed, Planned, or Recommended:

Conclusion

Although you cannot predict the future, and being prepared for the unexpected is often tricky, preventative measures remain the cornerstone of maintaining a happy and healthy working environment for you and your workforce.  

Incident reports not only define a guideline in any company’s incident protocol but they provide a means to avoid recurring mishaps and create change. 

This is why it is crucial to have a comprehensive and relevant incident report form prepared for any incidents that may arise. By abiding by your jurisdiction’s law and legislation and considering the four components prescribed above, you will be well-prepared to juggle incidents effectively.

Responding to workplace incidents in a detail-oriented and timely manner will not only cultivate a safe workplace but also: 

  • Satisfy your employees that their employer is prepared to take the proper steps in any problem 
  • Ensure that all appropriate parties are fully aware of the incidents 
  • Establish a precedent and record of incidents for future reference 
  • Protect both you and your company and your employees from lawsuits and disputes

FAQs 

Here are some of the most common questions about incident report templates:

What is the purpose of incident reporting?

An incident report describes an event that requires an investigation and needs to be documented.

What is in an incident report?

Any event that has created and caused any sort of injury to an individual is considered an incident that needs necessary documentation in the form of an incident report.

Types of incident reports:

  1. Accident Forms
  2. Workplace Incident Report
  3. Edit Reports

Accidents happen, no matter what you do or the number of preventative measures in place. When accidents happen, it’s mandatory to learn from them. 

To perfect your documentation, it’s a great idea to look at some example incident reports at the workplace.

Incident report form templates can help you learn and ensure that nobody is subject to bad treatment because it contains information from the injured employee and eyewitnesses. In addition, these forms help fill in key details of news and figure out how the accident occurred precisely.

Josh Fechter
Josh Fechter is the founder of HR.University. He's a certified HR professional and has managed global teams across 5 different continents including their benefits and payroll. You can connect with him on LinkedIn here.