Title Page

  • Date

  • Prepared by

  • Division

General Information

  • Date the incident happened

  • Date and time of investigation

  • Exact location of incident
  • Take photo of the location where the incident occurred

Equipment Information

  • Type of equipment damaged

Accident Details

  • Describe the incident

  • Root cause of the accident?

  • Describe the damages

  • Take photos

Recommendation

  • State some recommendations

Completion

  • Full Name and Signature

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.