Accident Investigation Form

[PDF] Accident Investigation Tips with Reporting Form download in PDF

Accident Investigation Form. Complete and submit this form to the designated safety office within 3 working days of the accident/incident. Web included on this page, you will find an employee incident/accident report form, a supervisor's incident investigation report template, a statement of witness to accident template, an employee's return to work plan, and many more.

An accident incident report is a form that asks for details about an accident that occurs in a vehicle, school, or workplace in order to properly document what took place. Web accident investigation form step 1: Motor vehicle accident (crash) report; Web • create forms to be used for taking notes and documenting conditions. Make five copies of this form for any lost time injury investigations. Notify safety specialist within 24 hours of incident(employee injury, near hit, property damage). Injured employee (complete this part for each injured employee) name of employeedate of birth departmentoriginal hire date job title shift start time months in current job other body part injurednature of injuryarmaccident typeelbowaccident agentwristdescription of injury handfinger toes malefemale How to conduct an incident investigation. • identify documents that need to be collected. It shall be completed in a timely manner following an incident, and can also be used to investigate a near miss event that could have resulted in an accident or injury.

Web • create forms to be used for taking notes and documenting conditions. Web updated august 04, 2022. Web this form is to be completed by the supervisor of an employee that has experienced an incident resulting in a serious injury or illness. Web motor vehicle accident (crash) report. Web accident investigation form step 1: Injured employee (complete this part for each injured employee) name of employeedate of birth departmentoriginal hire date job title shift start time months in current job other body part injurednature of injuryarmaccident typeelbowaccident agentwristdescription of injury handfinger toes malefemale • identify documents that need to be collected. How to conduct an incident investigation. Please remember to sign and date the form. Complete this form as soon as possible after an incident that results in serious injury or illness. Use this vehicle accident investigation report template to document information about the employee and vehicle involved in the accident.