Information

  • Incident summary

  • Date of investigation

  • Prepared by

  • Location
  • Personnel involved from GN (If more than one ask them to generate their own report - more information and photographic evidence is better than less)

Investigation

Essential details

  • Select the date and time of the incident

  • Enter the road name including nearest junction details

  • Select the weather conditions

  • Night time?

Summary of the accident

  • undefined

Accident plans

  • Add photos of the position of the vehicles at the time of the accident

  • Select the approximate speed at the time of impact

  • Were there any witnesses to the accident? If so give details including full contact details

Information given to

  • Were Police called? Details of who attended and any reference given

  • To which hospital were the injured parties taken

  • Ambulance called? Give details of who attended, call sign etc

  • Fire & Rescue Service called? Record officer in charge or photo of appliance identification

  • Insurance company informed - give reference received

Impact of Accident

  • Personal Injury details

  • Vehicle Damage details

Root Cause

  • What was the immediate cause of the incident?

  • Were there any underlying causes?

Corrective Actions

  • Are there any corrective actions required?

  • Detail any corrective actions/follow up required

Ongoing Monitoring

  • Does the employee require any on going support?

  • What additional support can the company give the employee?

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.