What goes on an incident report?

What happened, when and where, who was involved, who saw it, what was done right away, what contributed and what will change. Keep it factual.

Does every incident get reported?

Many sites want every injury, property damage event and near miss written down, even small ones. Your company procedure sets the rule. Whether an injury goes on the OSHA log is decided by the current recordkeeping rule, 29 CFR 1904.

Who should review the report?

The crew lead or supervisor reviews it first, then the safety lead. Follow your company procedure for who signs and how fast.

Free template

An incident report form to fill out the same day.

Write down what happened, who was there and what you did right away. Then list what contributed and who fixes what. Print the sheet or save it as a PDF.

Also calledAccident report form, Workplace incident report, Injury report form, Safety incident report

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Free to print, copy and change. It’s a starting point. Add the lines your equipment and your rules need.

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Incident report form

Date of incident

Time

Location

Reported by

Job or project

Report date

What happened

Facts only. Say what you saw, not who is to blame.

People involved

Name

Role or crew

What they were doing

Injured? Y/N

Witnesses

Name

Company or crew

Phone

Immediate action and first aid

If anyone needs more than basic first aid, get medical help.

Contributing factors

Check all that apply.

Rushed or behind schedule
Missing or unclear procedure
Equipment problem
Tool or guard missing
Housekeeping
Weather or lighting
Not enough training
Not enough people
Communication gap
Fatigue

Corrective actions

Action

Owner

Due date

Done

Reviewed by

Whether it's recordable is decided by the current OSHA recordkeeping rules (29 CFR 1904). Check the current rule.

Reported by (name, signature, date)

Supervisor reviewed (name, signature, date)

A starting point. Adapt it to your equipment, your procedures and the rules that apply to you.Free template from portalbaseai.com

How to use it

Three habits that make it worth filling out.

Step 1
Fill it out the same day
Details fade fast. Write it while people can still remember who stood where.
Step 2
Stick to what you saw
Describe the event, not the person. Fault gets sorted out later, after the facts are down.
Step 3
Give every fix an owner
An action with no name and no date doesn't get done. Check the list at the next safety meeting.

Do this on a phone instead of paper.

Report an incident on a phone, with photos and the people involved, no signal needed. Corrective actions get an owner and a due date, and the record is kept for you.

Book a walkthrough See how incident reporting works

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Common questions

What goes on an incident report?: What happened, when and where, who was involved, who saw it, what was done right away, what contributed and what will change. Keep it factual.
Does every incident get reported?: Many sites want every injury, property damage event and near miss written down, even small ones. Your company procedure sets the rule. Whether an injury goes on the OSHA log is decided by the current recordkeeping rule, 29 CFR 1904.
Who should review the report?: The crew lead or supervisor reviews it first, then the safety lead. Follow your company procedure for who signs and how fast.

Related and more free tools

Free tool

An incident report form to fill out the same day.

Incident report form

Three habits that make it worth filling out.

Fill it out the same day

Stick to what you saw

Give every fix an owner

Do this on a phone instead of paper.

Get new free tools by email.

Common questions

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