Incident report for construction sites

Incident report – construction site template

About the Incident report – construction site template

Use this template for the incident report for incidents involving personal injury and material damage on construction sites.

Related categories

Preview of the template

Close Call (near miss)

Risk to personal injury only - For all asset damage, environmental or reputational events please refer to following sections.

Close Call - no person has been injured but there was a real likelihood that someone may have been injured if no action was taken.

describe event

Action and recommendations

comments

Photos

Injury

Date and Time of incident

Name of injured person

DOB of the injured person

Contact details of injured person

Address of injured person

Name and contact details of witness

Activity when injury was sustained

Where did the injury occur?

Injury Location

Type of injury

Did a first aid responder provide first aid

If no please provide reason

Name and contact details of first aid responder

Details of treatment

Did the emergency services attend?

Which emergency services attended?

please provide names and contact detail is availible

Did the injured person stop work?

State date and time

Name of treating doctor or physician

comments

Photos of incident

Asset Damage

Date and Time of incident

Type of asset that has been damaged eg: vehicle, plant, scaffold, structure etc.....

How did damage occur

Details of responsible party

Has rectification of damage been actioned

Person/organisation completing rectification work

did the incident involve any of the following

Was the emergency services regulator notified/called to the scene?

Name/s and contact details of the person attended

If any person from an emergency service or regulatory office attends the site/scene please contact your line manager and HSE immediately.

comments

Photos

Environmental Impact

Date and Time of Event

Environmental Area that has been effected

clean up requirment

Has clean up been actioned?

by who?

Did the emergency services attend the scene?

person/organisation responsible for the incident

comments

Photos

Impact to Reputation

Date and Time of Event

please provide details

Did the media attend?

what is the likelihood of media interest?

have you had any calls from the media?

comments

Photos

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.