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Audit

Log of Work-Related Injuries and Illnesses

Job title

Date of injury or onset of illness

Where the event occurred

Type of incident

Describe injury or illness, parts of body affected, and object/substance that directly injured or made person ill.

Upload photos of incident

Classify the case. Check only one box for each case based on the most serious outcome for that case:

Please specify

No. of days the injured or ill worker was away from work

No. of days the injured or ill worker was on a job transfer or restriction

Completion

Observations and comments

Full Name and Signature of Record Keeper

OSHA 300 Log Checklist

Created by: SafetyCulture Staff | Industry: General | Downloads: 23

This OSHA 300 Log of Work-Related Injuries and Illnesses has been converted into an iAuditor digital template based on OSHA’s Form 300. Create a new audit for each reportable case.

Signup for a free iAuditor account to download and edit this checklist. It will be added to your free account and you will be able to conduct inspections from your mobile device.

Download and edit this free checklist

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Audit

Log of Work-Related Injuries and Illnesses

Job title

Date of injury or onset of illness

Where the event occurred

Type of incident

Describe injury or illness, parts of body affected, and object/substance that directly injured or made person ill.

Upload photos of incident

Classify the case. Check only one box for each case based on the most serious outcome for that case:

Please specify

No. of days the injured or ill worker was away from work

No. of days the injured or ill worker was on a job transfer or restriction

Completion

Observations and comments

Full Name and Signature of Record Keeper