Get the free Injury Investigation Form

This form is to be completed for all First Report of Injury or Illness Forms by a Safety Coordinator or Supervisor and must be filed in the injured employee's departmental file.

How to fill out injury investigation form

How to fill out Injury Investigation Form

1. Obtain a copy of the Injury Investigation Form from your supervisor or health and safety department.
2. Fill in the date and time of the incident at the top of the form.
3. Provide a detailed description of the injury, including how it occurred and any immediate actions taken.
4. Include the names and contact information of any witnesses present at the time of the injury.
5. Mention the location of the incident and any specific conditions that may have contributed to the injury.
6. Attach any relevant photos or evidence that support your description of the incident.
7. Sign and date the form to confirm the information is accurate.
8. Submit the completed form to your supervisor or designated safety officer for review.

Who needs Injury Investigation Form?

1. Employees who have been injured at work.
2. Supervisors who need to document incidents involving injuries.
3. Health and safety officers responsible for analyzing workplace incidents.
4. Legal representatives or insurance companies that may require documentation of workplace injuries.

For pdfFiller’s FAQs

What is Injury Investigation Form?

The Injury Investigation Form is a document used to collect detailed information regarding an incident where an injury has occurred, usually in a workplace or organizational setting.

Who is required to file Injury Investigation Form?

Typically, the form must be filed by supervisors, managers, or designated personnel responsible for safety and compliance in the workplace when an injury occurs.

How to fill out Injury Investigation Form?

To fill out the form, provide information regarding the injured person, details of the incident, witnesses, and any immediate actions taken. Ensure to follow any specific guidelines provided by the organization.

What is the purpose of Injury Investigation Form?

The purpose of the Injury Investigation Form is to document the details surrounding an injury to analyze the causes, prevent future occurrences, and comply with regulatory requirements.

What information must be reported on Injury Investigation Form?

Information that must be reported includes the date and time of the incident, location, description of the injury, involved parties, witness statements, and any corrective actions taken.