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EMPLOYEE INCIDENT REPORT Note: Please complete this form and return it to your supervisor immediately. Please complete each question and if you need medical attention, call: Nancy Thompson, HR Assistant

How to fill out employee incident report

How to fill out an employee incident report:

1. Start by providing your personal information, such as your name, job title, and contact details. This will help identify the person filing the report.
2. Clearly describe the incident in detail, including the date, time, and location. Provide a factual account of what happened and avoid adding any personal opinions or assumptions.
3. List any witnesses or individuals involved in the incident. Include their names, job titles, and contact information if possible. This information will be helpful for further investigation if needed.
4. Explain the circumstances surrounding the incident and any factors that may have contributed to it. This could include equipment failure, inadequate training, or any other relevant factors.
5. Document any injuries or damages that occurred as a result of the incident. Provide specific details about the nature and extent of the injuries or damages sustained.
6. If applicable, include any actions taken immediately after the incident, such as administering first aid, contacting emergency services, or implementing safety measures.
7. Lastly, sign and date the report to confirm its accuracy and completeness. It's essential to keep a copy of the incident report for your records.

Who needs an employee incident report:

1. Employers: Incident reports help employers maintain a safe and secure working environment. They can use these reports to analyze trends, identify potential hazards, and make necessary changes to prevent future incidents.
2. Human Resources: Human resources departments need incident reports for various reasons, such as ensuring compliance with workplace safety regulations, managing insurance claims, and conducting investigations or disciplinary actions when necessary.
3. Employees: Filling out an incident report allows employees to document any workplace incidents that may have occurred. This protects their rights and helps ensure that proper action is taken to address the situation and prevent similar incidents in the future.

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