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Incident investigation form

Incident investigation form

Document and analyze workplace incidents effectively with this comprehensive incident investigation form. It helps identify causes and implement corrective actions. Use this form to enhance safety and prevent future occurrences.

Use this template
or download pdf
Incident investigation form

Document and analyze workplace incidents effectively with this comprehensive incident investigation form. It helps identify causes and implement corrective actions. Use this form to enhance safety and prevent future occurrences.

Use this template
or download pdf

About the Incident investigation form

Using an incident investigation form template is crucial for systematically analyzing workplace incidents and preventing future occurrences. This template serves you by providing a structured framework to document all relevant details, from initial observations to root cause analysis. 

The primary purpose of an incident investigation form is to enhance workplace safety and compliance. It helps you identify patterns and underlying issues, enabling you to implement targeted improvements that reduce the likelihood of repeat incidents. 

Additionally, using a template promotes consistency across investigations, ensuring that no critical detail is overlooked. By integrating this form into your safety management processes, you can improve documentation accuracy, foster a culture of safety, and protect your organization from potential liabilities.

Key elements of an incident investigation form checklist

An incident investigation form checklist is essential for capturing detailed information and improving your documentation process. Here are the key elements that should be included:

  • Incident description: This section allows you to record the specifics of what happened, where, and when. Providing a clear overview of the incident’s context helps set the stage for a thorough investigation. A well-documented description ensures that all team members have a consistent understanding of the incident.
  • Witness statements: Gathering accounts from those who observed the incident is crucial for understanding different perspectives. This section helps identify contributing factors and can be pivotal in uncovering the root cause. Including detailed witness statements enhances the accuracy and reliability of your investigation.
  • Root cause analysis: This part of the template is where you dig deeper into why the incident occurred. Identifying underlying issues allows you to implement corrective actions that prevent recurrence. This analysis is critical for enhancing safety and ensuring compliance with industry standards.
  • Corrective actions: Clearly outlining the steps needed to address the root causes ensures accountability. Documenting these actions helps track progress over time and ensures that preventive measures are effectively implemented. This section is vital for optimizing your incident management process and improving overall workplace safety.

When to use an incident investigation form template

Using an incident investigation form template is crucial in scenarios where you need to document workplace incidents comprehensively and consistently. This template is particularly beneficial after accidents or near misses, as it helps you capture all relevant details quickly and accurately.

In high-risk industries like construction or manufacturing, where safety is paramount, an incident investigation form template helps maintain compliance with regulations and standards. It also proves invaluable during safety audits, providing a clear record of past incidents and the measures taken to address them. 

Streamline your incident management process by using the template to ensure thorough documentation and improve overall workplace safety.

Related categories

  • Health and safety management templates
  • General templates
  • Incident management templates
Preview of the template
Audit
Incident Details
List the names of people involved in the incident:
What happened?
What task was performed at the moment of the incident
Attach photo proof of incident:
Attach photo evidence of the surrounding environment:
People in the incident investigation team:
Contributing Factors
Choose all the relevant contributing factors for each of the sections below.
Environmental factors
Equipment/ Materials factors
Work systems factors
People factors
Attach photo proof of any contributing factors:
Sign off
Person involved in the incident:
Name and signature of the supervisor:

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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.

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Template collections

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

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Use cases

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

Incident management softwareIncident report softwareSafety Incident Reporting SoftwareRisk management software for anticipating and adressing safety risks
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Other resources

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

Frequently asked questions

How can incident investigation forms prevent future workplace accidents?

Incident investigation forms help prevent future workplace accidents by providing a structured method to document and analyze incidents. By identifying root causes and implementing corrective actions, these forms ensure that similar incidents are less likely to occur, enhancing overall workplace safety.

What should be included in an effective incident investigation report?

An effective incident investigation report should include details like the incident description, witness statements, root cause analysis, and corrective actions. These elements ensure a comprehensive understanding of the incident and facilitate the implementation of measures to prevent recurrence.

Why do companies need to analyze incidents systematically?

Systematic analysis of incidents is crucial for companies to identify underlying issues and implement corrective actions. This process not only prevents future incidents but also improves safety protocols and compliance with industry standards, reducing potential liabilities and enhancing operational efficiency.

What are the benefits of using digital tools for incident reporting?

Digital tools for incident reporting offer benefits such as easy access, real-time updates, and streamlined data collection. They enhance accuracy and collaboration, ensuring that all relevant information is captured efficiently and shared with the necessary team members for quicker resolutions and improved safety outcomes.


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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