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    Worksite Incident / Injury Report Form

    Free

    Every workplace should have a Worksite Incident / Injury Report Form available for employees and contractors to use to report an accident or mishap.

    • A report should be filled out whether or not the incident resulted in an injury. Recording near misses is crucial to developing good workplace safety policies.
    • A witness filling out the form must report whether there was an injury, what the extent of the injury was, and what treatment was administered onsite (if any).
    • The employer also completes part of the form with respect to time at work missed by the injured person, the results of the incident investigation, a risk assessment, and actions taken to prevent a recurrence.

    Keep your employees aware of work-related safety issues, and make sure that everyone knows how to fill out and submit the Worksite Incident / Injury Report Form. Download a free copy for your workplace.

    Download Type: Microsoft Word
    Last Updated: 14-April-2016
    SKU: 9152
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