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.
Free Incident Report Templates & Forms - Smartsheet
2017年1月3日 · Download free, easy-to-use incident report templates in Microsoft Word & PDF for work, school, or project management environments.
Fill out this form to report a workplace incident that resulted in injury, illness, or a near miss. Return completed form to: THIS FORM SERVES TO DOCUMENT select all that apply. LOST TIME / INJURY.
EMPLOYEE INCIDENT / ACCIDENT REPORT. Did anyone see you get hurt? Did you report this incident to anyone? Please describe the first aid administered. Was medical treatment necessary? Have you ever had a similar injury? Has a similar injury been treated?
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" event that could have resulted in an accident or injury. Return completed form to:
WORK-RELATED ACCIDENT / INJURY REPORT FORM INSTRUCTIONS CLAIM NO. This form shall be completed as soon as possible following an employee - related accident or injury. If the employee is unable, the supervisor shall complete this form, and then submit it to the Human Resources office. PERSONAL INFORMATION EMPLOYEE NAME SOCIAL SECURITY NO.
EMPLOYEE’S FIRST REPORT OF INJURY FORM. INSTRUCTIONS Using this form, employees shall report all work-related accidents, injuries, illnesses, or unplanned events which could have resulted in an injury or illness. Once completed, this form shall be given to …
employee’s first report of injury form INSTRUCTIONS Employees shall report all work-related accidents, injuries, illnesses - orunplanned events which could have resulted in an injury or illness - using this form.
WORKPLACE INCIDENT REPORT FORM. INSTRUCTIONS . Fill out this form to report a workplace incident that resulted in injury, illness, or a near miss. Return completed form to:
DATE OF INCIDENT. TIME OF INCIDENT. INCIDENT DESCRIPTION. In as much detail as possible, describe what caused the incident / accident / injury, what you were doing just before the incident, and what you did after the incident. Name any objects or substances involved.