Free Incident Report Form TemplateFill in what happened, tick the kind of incident, add the person involved, witnesses and action taken, then print the report or save it as a PDF. Or leave it blank and print copies. No sign-up, and nothing you type is uploaded.

How to fill in an incident report in 3 steps

1. 1

   Say when, where and what

   The date, time and place, the kind of incident (injury, near miss, damage…), and who was hurt or involved and what treatment they had.

2. 2

   Describe it while it is fresh

   Write what happened step by step, who saw it, what was done right away, and what would stop it happening again.

3. 3

   Sign and keep it

   The person reporting signs, then a supervisor. Keep the report with your safety records and follow up on the fixes.

What to put on an incident report

• Who is reporting it, their job and phone number, and the date of the report
• The date, time and exact place of the incident
• The kind of incident: injury, illness, near miss, property damage, vehicle, theft or security
• The person hurt or involved, their role, the injury or damage, and any treatment
• What happened, in the order it happened, using facts rather than blame
• Witnesses and how to reach them, the action taken right away, and how to prevent it next time
• Signatures of the person reporting and a supervisor

Tips for a useful report

• Write it the same day, while people remember the details. Add photos or a sketch if they help.
• Report near misses too: they show where the next accident could happen.
• Stick to what was seen and done. Leave out guesses about who was at fault.
• Keep reports about injuries and health private, and share them only with people who need them.
• Check back later that the fixes in “How to stop it happening again” were really made.

OSHA rules for injuries at work (US)

• Many US employers must record work-related injuries and illnesses on OSHA Form 301 (Injury and Illness Incident Report) or an equivalent form within 7 calendar days of learning about them (29 CFR 1904.29).
• An equivalent form must have the same information as Form 301. This incident report is a general internal record, not an OSHA Form 301.
• A work-related death must be reported to OSHA within 8 hours, and an in-patient hospitalization, amputation or loss of an eye within 24 hours (29 CFR 1904.39).
• Workers’ compensation insurers and other countries have their own forms and deadlines. Check with your insurer and your local safety agency.