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OSHA incident investigation form

OSHA incident investigation form

Ensure compliance with OSHA standards using this detailed incident investigation form. It supports you in improving safety practices and regulatory compliance.

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The Lumiform application helps frontline teams uphold internal standards effortlessly.
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OSHA incident investigation form

Ensure compliance with OSHA standards using this detailed incident investigation form. It supports you in improving safety practices and regulatory compliance.

Use this template with Lumiform

The Lumiform application helps frontline teams uphold internal standards effortlessly.
  • Customize this template or build your own
  • Fill out templates via mobile app
  • Assign and track corrective actions
  • Get reports and analyse your data
Prices start from ░░░ per month
Book a demo
Learn more
or Download template as PDF

The OSHA incident investigation form empowers safety teams to thoroughly record workplace incidents and pinpoint their root causes. With this template, you can capture critical incident details, analyze contributing factors, and develop effective corrective actions to prevent future occurrences.

For example, you can use this form to investigate machine-related injuries and uncover systemic issues in training procedures. A study found that companies with inspections saw a 9.4% reduction in injury claims over four years compared to similar uninspected workplaces. We designed this template so you can leverage incident reporting into a powerful safety improvement tool.

Related categories

  • Health and safety management templates
  • Risk management and compliance templates
  • General templates
  • Incident management templates
Preview of the template
Page 1
Incident Details
Date of Incident
Location of Incident
Section
Incident Description
Injured/Affected Persons
Name of Injured/Affected Person
Job Title
Nature of Injury/Illness
Body Part Affected
Treatment Provided
Incident Investigation
Immediate Cause
Root Cause
Corrective Actions Taken
Preventive Measures
Reporting Information
Reported To
Report Date
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.

OSHA regulations: A compliance guide for professionalsIncident management: A deep diveHow to write an incident report: Your complete guide
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Template collections

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Top 4 free OSHA 301 form templates for workplace safetyTop 7 free incident investigation form templates for complianceBest 27 free OSHA inspection checklist templates
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Check out how the Lumiform software can be utilized for related use cases.

OSHA compliance softwareIncident management softwareIncident report softwareSafety Incident Reporting Software
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Other resources

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

5 types of incident reportsHow to perform safety inspectionsHow to write a workplace safety policy4 benefits of safety management and how to communicate them

Frequently asked questions

How can I ensure my incident investigation identifies the true root causes?

Focus on asking “why” multiple times to dig deeper than immediate causes. Document all contributing factors in the form, including equipment conditions, training adequacy, procedural issues, and environmental factors. Avoid stopping at human error explanations and instead examine what system failures allowed the error to occur. The corrective actions section should address these underlying causes, not just symptoms.

What information should I gather immediately after an incident occurs?

Secure the scene first, then document everything while memories are fresh. Take photos of the incident area, equipment involved, and environmental conditions. Record names and contact information of all witnesses, and conduct brief initial interviews. Note the date, time, exact location, and sequence of events. This immediate documentation is crucial for accurate root cause analysis later.

When is an incident serious enough to warrant using this investigation form?

Any incident that results in injury, illness, property damage, or a near miss that could have caused harm warrants formal investigation. Even seemingly minor incidents can reveal serious underlying safety issues. OSHA requires documentation for recordable injuries, but investigating all incidents, including near misses, provides valuable data for preventing future accidents and demonstrates your commitment to workplace safety.

How can I use the completed incident investigation forms to improve our safety program?

Review completed forms regularly to identify patterns and trends across multiple incidents. Look for recurring locations, times, equipment, or procedures associated with incidents. Use this data to prioritize safety improvements and measure their effectiveness. Share anonymized findings with staff to build safety awareness. The preventive measures section becomes a valuable resource for updating training programs and safety procedures.


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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