SafetyCulture Staff

IT Incident Report Template

Use this template to report incidents concerning the server, the server room, and other IT-related incidents. Use your mobile device to take photo evidence and record if there’s damage to property or injury to staff.

Use this Template

Print as PDF

Use this Template

Go digital today!

Convert your paper checklists into digital forms

Scan this QR code to use this paper checklist on your smartphone or tablet or visit https://safetyculture.com/

Title Page

Server / Site
Conducted on
Prepared by
Location

Incident Details

Date and time of incident
What was the Incident?
Were there any injuries?
Description of injury
Take photo of injury
Was there any damage to property or equipment?
Description of damage
Take photo/s of damage
What caused the incident?
Take photo of surrounding environment including any comments
What actions will be taken to eliminate future repeats of the incident?
Management comments

Sign Off

Signed off by supervisor when corrective actions have been adopted and monitored
Supervisor sign off

SafetyCulture Staff

IT Incident Report Template

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.