Title Page

  • Who was injured?

From: Center Safety Officer, Vance Schuening

  • To:

  • RE: Accident Prevention Plan for:

  • SNJCC Case #:

  • Sedgewick Claim #:

  • Date of Injury

  • Log # in book

  • Associated Cases Included:

  • Location of injury:

  • Type of Injury:

  • Object causing injury:

Description of incident:

  • undefined


  • undefined

Root Cause[s]

  • undefined

Process, Policy or Procedure Enhancement

  • undefined

The templates available in our Public Library have been created by our customers and employees to help get you started using SafetyCulture's solutions. The templates are intended to be used as hypothetical examples only and should not be used as a substitute for professional advice. You should seek your own professional advice to determine if the use of a template is permissible in your workplace or jurisdiction. You should independently determine whether the template is suitable for your circumstances.