Incident Report Form
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Form · FORM-30057

The Incident Report Form documents any workplace event that may result in injury or damage: injuries and accidents, near misses, property or equipment damage, and environmental, quality or IT incidents.
It records the incident's details and type, whether it is notifiable and how the regulator was told, what happened, the people involved and the witnesses, the actions taken, any injury or illness, property damage and the incident's impact, and who reported it.
A section for official use lets the supervisor or safety officer classify the incident's severity, assign an investigation, record corrective actions and close it with the lessons learned. It is part of the Health and Safety Manual, whose documents refer to each other.
Incident Report Form
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