Initial Incident Investigation

• Site conducted

  Select

• Conducted on

  Date

• Prepared by

• Incident Type

  Select

• Incident Location

• Date & Time of Incident

  Date

• First Reported by

• When was it first reported?

  Date

• Did anybody get injured during the incident?

  Yes

  No

  N/A

• Yes

  No

  N/A

Description Of Incident

• Witness Statement - Name

• Witness Statement 2 - Name

• Witness Statement 3 -Name