Information

  • Audit Title

  • Document No.

  • Client / Site

  • Conducted on

  • Prepared by

  • Location
  • Personnel

  • 1. What is the injured associate’s name?

  • 2. What happened (as much detail as possible to avoid follow up questions)?

  • Add media

  • Add media

  • 3. Who called in the injury?

  • 4. Was professional medical attention required, and if so, when do we expect the injured associate to return to work?

  • 5. What was the root cause?

  • 6. What is the suggested corrective action?

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.