Injury/Incident Report Form 501


  • Complies with current regulations and legislation 
  • Instantly downloadable document  
  • Compatible with Microsoft Word and editable to add your brand logo and colours 
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The Injury/Incident Report Form is used for reporting accidents, near misses, injuries, security breaches, safety issues, equipment failures, and property damage.  

An Injury/Incident Report Form is critical in any workplace as it records what, when, who and how the incident occurred in case of future claims or proceedings. 

The form includes the following fields: 

  • Details of injured person 
  • Details of injury 
  • Witnesses 
  • Statements 
  • Management sign-off 
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