This form is to be completed by the supervisor of an employee that has experienced an incident resulting in a serious injury or illness. It shall be completed in a timely manner following an incident, and can also be used to investigate a "near miss"
Incident Investigation - Overview - Occupational Safety and …
Investigating a worksite incident- a fatality, injury, illness, or close call- provides employers and workers the opportunity to identify hazards in their operations and shortcomings in their safety and health programs.
Employer Incident Investigation Report (Form 52E40)
Employer Incident Investigation Report (Form 52E40) Employers are responsible for investigating certain incidents or near misses that take place in the workplace and submitting an investigation report to WorkSafeBC.
OSHA created this Guide to help employers conduct workplace incident investigations using a four‐step systems approach. This process is supported by an Incident Investigation Form, found in Appendix A, which employers can use to be sure all details of …
Free Workplace Accident Report Templates | Smartsheet
2019年9月19日 · 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 helpful workplace accident report forms.
Complete an Incident Investigation Report after you have gathered all possible evidence. See the text for information on how to complete this form. ©2009 National Safety Council.
Free Incident Report Templates - PDF | Word – eForms
2024年9月30日 · Incident Report Templates (18) | Sample. An incident report is used to formally document an event that involves an accident, injury, property damage, or other unusual activity. Commonly used in the workplace, an incident report can help employers reduce liability by addressing problematic employees or processes in an effort to prevent harmful ...
Accident Investigation Report Templates | PDF | SafetyCulture
2024年10月14日 · Download and use free accident investigation report templates. Perform efficient accident investigations with digital and PDF templates.
Incident Report Template (Free) - Word, PDF, and Excel
Freely download professionally created safety incident report template. You can download the template in Microsoft Word, PDF or Excel Spreadsheet formats. No login required.
Please use this form to report near-misses and assist us in preventing future incidents and making the Company a safer workplace. Please submit this form to the main office or your supervisor. For questions or cases deemed immediately dangerous, call the main office at 555-555-5555.