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Accident Investigation

The document provides a template for reporting accident investigations including sections for details of the incident, cause, witnesses, and corrective actions. It includes fields for project details, those involved, and injury/damage information.

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Malik Khuram Shazad
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29 views1 page

Accident Investigation

The document provides a template for reporting accident investigations including sections for details of the incident, cause, witnesses, and corrective actions. It includes fields for project details, those involved, and injury/damage information.

Uploaded by

Malik Khuram Shazad
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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11/22/2020 Accident_Investigation

TOOLBOXTOPICS.COM
Project Name: Project Location:

Investigated By: Date: Supervisor

Equipment involved

ACCIDENT/INCIDENT INVESTIGATION

REPORT

Personal Injury____________________________ Property Damage__________________________


Name:_________________________________Employee#: _________________________________
Hire Date:_______________________Performing Regular Job:__________________________________________
Type of Injury:__________________________________Nature of Injury:___________________________________
Part of Body Injured:________________________________Nature of Damage:______________________________

Description of Accident: (What occurred? Include photos and diagram.)

Cause of Accident: (How and why did it occur. Documentation to support training.)

Witnesses: (Anyone who may have seen the accident occurred. Name, company, phone#)

Corrective Actions: (Actions taken to prevent recurrence.)

This document contains privileged, limited-use safety and privacy act protected information. Unauthorized use or disclosure can subject
you to criminal prosecution, termination of employment, civil liability, or other adverse actions.

www.toolboxtopics.com/Accident_Investigation_check.htm 1/1

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