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Health and safety incident report form

Health and safety incident report form

A health and safety incident report form helps you document workplace accidents, injuries, or near-misses in detail. It ensures accurate reporting, identifies root causes, and supports compliance with safety regulations. Use this tool to track incidents, implement corrective actions, and improve workplace safety practices.

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

A health and safety incident report form helps you document workplace accidents, injuries, or near-misses in detail. It ensures accurate reporting, identifies root causes, and supports compliance with safety regulations. Use this tool to track incidents, implement corrective actions, and improve workplace safety practices.

Use this template
or download pdf

About the Health and safety incident report form

A health and safety incident report form template helps you document workplace incidents quickly and accurately. You can use it to record key details like the nature of the incident, those involved, and corrective actions taken. This ensures consistent and thorough documentation, which is essential for compliance and follow-up. 

Using this template saves time by providing a structured format that reduces errors and ensures all critical information is captured. It also helps you analyze trends, identify recurring risks, and implement preventive measures to improve workplace safety. 

A template such as this serves you by streamlining your reporting process, improving accountability, and ensuring compliance with health and safety regulations. It’s a vital tool for creating a safer work environment and protecting your team from future risks. 

Who should use a health and safety incident report form template

  • Safety officers: To document workplace incidents accurately and ensure compliance with safety regulations. 
  • HR managers: To track incidents and implement corrective actions to improve employee safety. 
  • Supervisors and team leaders: To report on-site incidents promptly and ensure follow-up actions are taken. 
  • Compliance officers: To maintain thorough records for audits and investigations. 
  • Business owners and managers: To analyze trends, reduce risks, and create a safer work environment. 

Best practices to get the most out of a health and safety incident report form template

To maximize the effectiveness of a health and safety incident report form template, start by customizing it to your workplace’s specific needs. Include fields for details like the type of incident, location, and contributing factors to ensure comprehensive documentation. 

Train your team on how to use the template correctly. Emphasize the importance of reporting incidents promptly and providing accurate information. Clear and timely reporting helps prevent recurring risks and ensures swift corrective actions. 

Use the template to analyze trends by reviewing past reports. Look for patterns in incidents to identify areas where preventive measures can be implemented. 

Finally, follow up on every report by assigning corrective actions and tracking their completion. Regularly review and update the template to reflect changes in workplace policies or safety standards, ensuring it remains relevant and effective. 

Document incidents with ease using this template 

Ensure accurate and consistent incident reporting with a health and safety incident report form template. Download it or start using it directly in Lumiform. With its customizable features, you can adapt the template to your workplace needs and create a safer environment for everyone. 

Related categories

  • Health and safety management templates
  • General templates
  • Inventory management templates
  • Workplace safety templates
Preview of the template
Page 1
Incident Details
Date of Incident
Location of Incident
Incident Description
Injured Person Details
Name of Injured Person
Age
Gender
Contact Number
Address
Incident Type
Type of Incident
Briefly Describe Incident Type
Injury Details
Type of Injury
Body Part Affected
Severity of Injury
Witness Details
Witness Name
Witness Contact Number
Witness Statement
Corrective Actions
Immediate Actions Taken
Preventive Measures
Reporting Details
Reported By
Reporting Date
Supervisor Name
Supervisor Signature

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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.

Occupational health and safety: A comprehensive guideHow to write an incident report: Your complete guideIncident management: A deep diveBehavior based safety: Your guide for improving workplace safety
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Template collections

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

10 powerful free health and safety policy templates4 free workplace incident report templates6 free health and safety risk assessment templates
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Use cases

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5 types of incident reports10 reasons why workplace safety is importantHow to perform safety inspections4 benefits of safety management and how to communicate them

Frequently asked questions

What is a health and safety incident report form used for?

A health and safety incident report form is used to document workplace accidents, injuries, or near-misses. It ensures all critical details are recorded, helps identify the root cause of incidents, and supports compliance with safety regulations while improving risk management.

Why is accurate incident reporting important?

Accurate incident reporting helps identify patterns and root causes of workplace hazards. It ensures corrective actions are taken to prevent future incidents and protects your organization from legal or compliance issues. Thorough documentation builds accountability and improves workplace safety.

When should a health and safety incident report template be used?

This template should be used immediately after any workplace accident, injury, or near-miss. Prompt reporting ensures all details are captured accurately, enabling quick corrective actions and preventing similar incidents in the future.

How can incident reporting improve workplace safety?

Incident reporting helps track trends, identify recurring risks, and implement preventive measures. By using a structured form, you can streamline the reporting process, ensure consistency, and make data-driven decisions to create a safer work environment.


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.
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