Updated January 23, 2024
An incident report is used to formally document an event that involves an accident, injury, property damage, or other unusual activity. Commonly used in the workplace, an incident report can help employers reduce liability by addressing problematic employees or processes in an effort to prevent harmful incidents from recurring.
When to Write?
An incident report should be completed as soon as possible after the event to get the most accurate testimony from witnesses.
Table of Contents |
By Type (18)
What Should be Included?
An incident report should include the following details:
- The person affected and their contact information
- A factual description of the incident, including location, date, and time
- A description of the incurred injuries if any
- Any involved parties or witnesses and their contact information
How to File an Incident Report
Procedures for incident reporting can vary from company to company. While some employers may prefer their employees to report incidents to their direct supervisor or to the HR department, others may have an online incident reporting system where employees can submit the form virtually.
If your company’s process for incident reporting was not covered as part of your onboarding process, check your employee handbook or ask your supervisor.
Sample
INCIDENT REPORT FORM
Use this form to report accidents, injuries, medical situations, criminal activities, traffic incidents, or student behavior incidents. If possible, a report should be completed within 24 hours of the event.
Date of Report: [DATE]
I. PERSON INVOLVED.
Full Name: [NAME] Address: [ADDRESS]
Identification: ☐ Driver’s License No. [#] ☐ Passport No. [#] ☐ Other: [OTHER]
Phone: [PHONE NUMBER] E-Mail: [E-MAIL ADDRESS]
II. THE INCIDENT.
Date of Incident: [DATE] Time: [TIME] ☐ AM ☐ PM
Location: [LOCATION]
Describe the Incident: [DESCRIBE THE INCIDENT]
III. INJURIES.
Was anyone injured? ☐ Yes ☐ No
If yes, describe the injuries: [DESCRIPTION OF INJURIES]
Were there witnesses to the incident? ☐ Yes ☐ No
If yes, enter the witnesses’ names and contact info: [NAMES OF WITNESSES]
IV. POLICE / MEDICAL SERVICES.
Police Notified? ☐ Yes ☐ No If yes, was a report filed? ☐ Yes ☐ No
Was medical treatment provided? ☐ Yes ☐ No ☐ Refused
If yes, location of the medical treatment: ☐ On-site ☐ Hospital ☐ Other: [OTHER]
V. PERSON FILING REPORT.
Signature: ________________________ Date: _____________
Print Name: ________________________
OFFICE USE ONLY
Report received by: [NAME] Date: [DATE]
Follow-up action taken:
Action Taken: [DESCRIBE]