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  • Accident and Incident

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    kkhan.yasim75
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    An accident or incident report was filed on [Date time of event] for an event that occurred at [Location] within the [Department] of [Company]. The event involved [Type of Accident/event] that resulted in [Harm (or potential for harm)] and involved the employee [Employee involved in event]. An investigation into the event details and any witness statements is required to determine appropriate follow-up actions.

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    An accident or incident report was filed on [Date time of event] for an event that occurred at [Location] within the [Department] of [Company]. The event involved [Type of Accident/event] that resulted in [Harm (or potential for harm)] and involved the employee [Employee involved in event]. An investigation into the event details and any witness statements is required to determine appropriate follow-up actions.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Flag for inappropriate content
    Download as pdf or txt
    9 views1 page

    Accident and Incident

    Uploaded by

    kkhan.yasim75
    An accident or incident report was filed on [Date time of event] for an event that occurred at [Location] within the [Department] of [Company]. The event involved [Type of Accident/event] that resulted in [Harm (or potential for harm)] and involved the employee [Employee involved in event]. An investigation into the event details and any witness statements is required to determine appropriate follow-up actions.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Flag for inappropriate content
    Download as pdf or txt
    of 1

    Accident or incident report

    Date time of event :


    Company : Department : Location :

    Type of Accident
    event : / incident report
    Injury ill health Incident ( near miss )

    Harm (or potential for harm : Fetal or major Serious Minor Damage property only

    Employee involved in event : Name : Phone NO :

    Position : Address :

    Brief description of event details of what


    happened where and emergency action taken

    Details of witness if any phone , name ,position ,etc.

    Investigation required : Yes Error reportable Date yes


    time reported :
    Investigation level : High Medium Low Minimal
    priority : Entry in accident book : yes
    Leader of investigation : Date time enter :

    Reported by : Position : Date : Signature :

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