Anonymous

INCIDENT REPORT**

Use this Template

Print as PDF

Use this Template

Title Page

Report Type
- Close Call
- Incident
Incident Type
- Injury/Illness
- Equipment/Property Damage
- Environmental Release
Incident Date & Time
Incident Location/Address
Incident Description (Include who, what, why & how)
How could have this close call/incident been avoided?
Report Completed By

Anonymous

INCIDENT REPORT**

Use this Template

Print as PDF

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.