Lumiform
Features Solutions Resources Templates Enterprise Pricing
Select a language
Englishen
Deutschde
Françaisfr
Españoles
Português (BR)pt-BR
en
Contact salesLog in
Sign up
Back
Englishen
Deutschde
Françaisfr
Españoles
Português (BR)pt-BR
Features Solutions Resources Templates Enterprise Pricing
Free demo
Log in
en
Book a personal demoView video demoContact sales
Explore
Resource hubCentral repository for all Lumiform resourcesCustomer storiesReal-world successes and experiences with Lumiform.
Learn
Template collectionsComprehensive collections of best practice templates.Topic guidesComprehensive safety, quality, and excellence insights.LexiconDefinitions key to quality, safety, and compliance.
Support
Developer's guideTechnical documentation for developers.Help centerAssistance with onboarding and platform mastery.
Featured reads
Explore our collection of 38 free preventive maintenance checklists

Template collection

Explore our collection of 38 free preventive maintenance checklists

Start reading
Your guide to performing and documenting efficient child care observation

Topic guide

Your guide to performing and documenting efficient child care observation

Start reading
Lumiform as customer journey mapping tool in gastronomy

Success story

Lumiform as customer journey mapping tool in gastronomy

Start reading
Book a personal demoView video demoContact sales
By industry
Food and hospitalityManufacturingConstructionRetailTransport and logisticsFacility managementView all industries
By business needs
Health and safety managementQuality managementOperational excellenceRisk management and complianceView all business needs
By use case
Safety management softwareEnergy audit appForklift inspection appBuilding management softwareVehicle inspection appQMS appKaizen method appProperty inspection appRestaurant inspection appElevator management appProject management softwareFire inspection app
View all app uses
Book a personal demoView video demoContact sales
Overview
Template libraryDiscover over 12,000 free, ready-made and expert proofed templates.
Use cases
CleaningMaintenanceRisk assessmentSupply chainIncident management
Business needs
Health and safety managementQuality managementOperational excellenceRisk management and compliance
Industries
Food and hospitalityManufacturingRetailTransport and logisticsConstructionFacility management
Book a personal demoView video demoContact sales
Overview
Product overviewAll features
Capabilities
Digitize
Form builderMobile AppActions
Automate
Workflow automationApprovalsIntegrations
Transparency and accountability
ReportsAnalytics
Orchestrate
Administration
Book a personal demoView video demoContact sales
Templates
Health and safety incident investigation report template

Health and safety incident investigation report template

Conduct thorough investigations with this health and safety incident report template. It provides a structured approach to analyzing incidents and implementing safety improvements. Use this template to enhance workplace safety and compliance.

Use this template
or download pdf
Health and safety incident investigation report template

Conduct thorough investigations with this health and safety incident report template. It provides a structured approach to analyzing incidents and implementing safety improvements. Use this template to enhance workplace safety and compliance.

Use this template
or download pdf

About the Health and safety incident investigation report template

Effective incident investigations are crucial for maintaining a safe workplace and preventing future accidents. A health and safety incident investigation report template is essential for documenting incidents accurately and efficiently. 

This template helps you capture all necessary details, analyze root causes, and implement corrective actions to prevent future occurrences. Whether you’re a safety officer in manufacturing or a compliance manager in construction, using this template ensures consistency in reporting and enhances your ability to maintain a safe work environment.

Key elements of a health and safety incident investigation report template

Understanding the key elements of a health and safety incident investigation report template is crucial for conducting thorough investigations. Here are the essential components you should include:

  • Basic incident information: Record essential details such as the date, time, location, and individuals involved in the incident. Capturing this information provides a clear context for the investigation and serves as a foundation for further analysis.
  • Comprehensive incident account: Offer a detailed description of the incident, outlining the sequence of events and any immediate actions taken. This comprehensive narrative aids in identifying contributing factors and helps clarify the circumstances surrounding the incident.
  • Analysis of contributing factors: Focus on identifying the factors that contributed to the incident, such as environmental conditions or procedural lapses. Understanding these factors allows you to address underlying issues and enhance preventive measures.
  • Action plan and resolution: Document the corrective actions implemented and any follow-up steps necessary to prevent recurrence. This section ensures that all responses are tracked and evaluated, fostering accountability and promoting a safer work environment.

By incorporating these elements into your health and safety incident investigation report template, you can create a comprehensive tool that enhances safety, ensures compliance, and optimizes your incident management processes.

How to customize your health and safety incident investigation report template

Customizing your health and safety incident investigation report template can make it more effective and tailored to your specific requirements. Start by adapting the incident information section to include fields that capture data unique to your industry or work environment. This ensures that you are collecting all relevant details for a comprehensive analysis.

You can also modify the root cause analysis component to incorporate specific criteria or methodologies that align with your organization’s safety protocols. This customization helps you focus on the most pertinent factors, enhancing the effectiveness of your corrective actions. Additionally, consider adding sections for specific follow-up procedures or compliance checks that are unique to your operations.

Finally, adjust the template to fit your organizational structure by incorporating role assignments or approval workflows. By aligning the template with your specific needs, you can streamline your incident management processes, improve documentation accuracy, and ensure that your safety strategies are both effective and efficient.

Related categories

  • Health and safety management templates
  • General templates
  • Incident management templates
Preview of the template
Page 1
Incident Details
Incident Date & Time
geolocation!!!
Persons Involved
Witnesses
Incident Description
Incident Investigation
Describe how the incident occurred
Identify the root cause(s)
Immediate actions taken
Contributing Factors
Corrective Actions Planned
Person(s) Responsible for Corrective Actions
Target Completion Date for Corrective Actions
Incident Classification
Incident Type
Severity of Incident
Lost Time Incident?
First Aid Provided?
Medical Treatment Provided?
Incident Reporting
Date Reported
Incident Reported by
Investigation Completion Date
Approvals
Manager Review
Manager Signature
Manager Review Date
Safety Manager Review
Safety Manager Signature
Safety Manager Review Date

More templates like this

5 why incident investigation template
5 why incident investigation template
Incident investigation template using 5 Why analysis
Incident management templates
Incident Investigation Template
Incident Investigation Template
Use this incident investigation template to do a root cause analysis for an incident or near-miss at a workplace.
Incident management templates
Incident investigation report template
Incident investigation report template
Use this template for an accident report to investigate accidents in detail.
Incident management templates
OSHA incident investigation form
OSHA incident investigation form
Detailed form for reporting OSHA incidents
Incident management templates
Workplace Incident Investigation Template
Workplace Incident Investigation Template
Use this Workplace Incident Template to uncover the circumstances and conditions that led to the event in order to prevent future incidents.
Incident management templates
Health and safety audit checklist
Health and safety audit checklist
Master health and safety audits with our detailed checklist. Boost compliance and operational efficiency through expert-driven strategies.
Risk assessment templates

Related resources

Access a complete set of resources aimed at maximizing safety, quality, and operational excellence, including detailed guides, related templates, and real-world use cases.

Topic guides

Read in-depth guides covering key topics related to this article.

How to write an incident report: Your complete guideIncident management: A deep diveOccupational health and safety: A comprehensive guideTake 5 safety: Your detailed guide for an incident-free workplace
See all topic guides

Template collections

See comprehensive collections of best practice templates related to this topic.

Top 7 free incident investigation form templates for compliance10 powerful free health and safety policy templatesCollection of 21 free incident report templates for every industry4 free workplace incident report templates
See all template collections

Use cases

Check out how the Lumiform software can be utilized for related use cases.

Incident management softwareSafety Incident Reporting SoftwareWorkplace AppIncident report software
See all use cases

Other resources

Explore all the additional resources we offer to assist you in mastering this topic.

5 types of incident reportsHow to write a workplace safety policyHow to perform safety inspections4 ways process improvement increases profits

Frequently asked questions

How does a health and safety incident report aid in compliance?

A health and safety incident report aids in compliance by ensuring that all incidents are documented systematically. This documentation helps you meet regulatory requirements, demonstrate due diligence, and provide a clear audit trail for any safety investigations.

What initial steps should I take following a workplace incident?

Following a workplace incident, prioritize the safety of all personnel and secure the area to prevent further harm. Begin documenting the incident details immediately, collect witness accounts, and initiate an investigation to identify causes and develop preventive strategies.

Why is adapting an incident investigation report template beneficial?

Adapting an incident investigation report template is beneficial because it allows you to tailor the document to your specific industry and organizational needs. This customization ensures that you gather the most relevant information, leading to more effective analysis and corrective actions.

How can I engage my team in the incident investigation process?

Engage your team by providing training on the importance of thorough incident reporting and encouraging open communication. Involve them in identifying contributing factors and developing corrective actions, fostering a culture of safety and accountability throughout the organization.


This template, developed by Lumiform employees, serves as a starting point for businesses using the Lumiform platform and is intended as a hypothetical example only. It does not replace professional advice. Companies should consult qualified professionals to assess the suitability and legality of using this template in their specific workplace or jurisdiction. Lumiform is not liable for any errors or omissions in this template or for any actions taken based on its content.
Lumiform logo
Platform
HomeSign upProductAll featuresPricingEnterpriseTrust and securityCustomer success offeringsDownload the app
Solutions
IndustriesFood and hospitalityManufacturingConstructionRetailTransport and logisticsFacility management
Business needsHealth and safety managementQuality managementOperational excellenceCompliance and risk management
Uses cases
Learn
Template collectionsTopic guidesLexiconHelp centerJournalInfographicsVideos
Resources
Lumiform templatesby industryby use caseby business needAll categories
Customer storiesDeveloper APIResource hubIntegrations
Company
AboutJobsLegalBook a demoContact sales
© 2025 LumiformTerms and conditionsPrivacyData processingSitemap
App StoreGoogle play