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SUPPLEMENTARY INCIDENT REPORT SAFETY DIVISION Preliminary Incident Report Safety Division Template and Guidelines Prepared by The Safety Division SUPPLEMENTARY INCIDENT REPORT TEMPLATE AND GUIDELINES

How to fill out preliminary incident report

How to fill out a preliminary incident report:

1. Start by gathering all relevant information about the incident, such as the date, time, and location. Include details about what happened, who was involved, and any witnesses present.
2. Clearly and accurately describe the incident in a concise manner. Use objective language and stick to the facts. Avoid adding personal opinions or assumptions.
3. Include any photos, videos, or other evidence that may support the incident report. Make sure to document any visible damage, injuries, or hazardous conditions that contributed to the incident.
4. Provide contact information for any individuals involved in the incident, including witnesses and those directly affected. Include their names, phone numbers, and email addresses if available.
5. If applicable, indicate whether law enforcement or emergency services were notified and provide details of their response. Include the names of any responding officers or emergency personnel.
6. Sign and date the preliminary incident report to indicate that the information provided is accurate to the best of your knowledge. Make sure to include your name, job title, and contact information for further clarification if needed.

Who needs a preliminary incident report:

1. Human resources departments often require preliminary incident reports to document workplace accidents or incidents that may require follow-up investigations or insurance claims.
2. Law enforcement agencies may use preliminary incident reports to collect initial information about crimes, accidents, or other incidents under their jurisdiction.
3. Insurance companies may require preliminary incident reports to process claims related to property damage, personal injury, or other incidents covered by insurance policies.
4. Occupational safety and health organizations may use preliminary incident reports to track and analyze workplace incidents, identify trends, and implement preventive measures.
5. Government agencies, such as transportation authorities or environmental agencies, may require preliminary incident reports to monitor and address incidents related to their specific jurisdiction or operations.

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