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ACCIDENT INVESTIGATION REPORT (Completed by the supervisor within 48 hours of the incident) (Continue On Reverse If Additional Space Is Necessary)
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How to fill out accident investigation report

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How to fill out an accident investigation report:

01
Begin by collecting all necessary information about the accident, including the date, time, and location. Take note of any witnesses or parties involved.
02
Describe the circumstances leading up to the accident in detail. Include any relevant factors such as weather conditions, equipment malfunction, or human error.
03
Document the injuries sustained by anyone involved in the accident, including yourself if applicable. Provide a clear account of the extent of the injuries and any medical treatment received.
04
Include a section for documenting any damage to property or equipment as a result of the accident. Take photographs if possible to support your report.
05
List any potential causes or contributing factors to the accident. This could include inadequate training, faulty equipment, or hazardous working conditions.
06
Provide a summary or conclusion to your investigation, presenting your findings and recommendations for preventing similar accidents in the future.
07
Sign and date the report, indicating your responsibility for its accuracy and completeness.

Who needs an accident investigation report?

01
Employers: Employers are required to investigate accidents that occur within the workplace to ensure the safety of their employees and to comply with regulatory guidelines.
02
Insurance Companies: Insurance companies may require an accident investigation report to process claims and determine liability.
03
Government Agencies: Government agencies, such as the Occupational Safety and Health Administration (OSHA), may request accident investigation reports to assess workplace safety and enforce regulations.
04
Legal Proceedings: In the event of a lawsuit or legal proceedings related to the accident, an accident investigation report can serve as valuable evidence.
05
Safety Committees: Safety committees within an organization may review accident investigation reports to identify trends or patterns and make recommendations for improving safety protocols.
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Accident investigation report is a detailed document that outlines the circumstances and causes of an accident.
Employers or authorities responsible for workplace safety are typically required to file accident investigation reports.
Accident investigation reports are typically filled out by documenting information about the accident, including date, time, location, persons involved, witnesses, and possible causes.
The purpose of accident investigation report is to identify the causes of an accident, prevent similar accidents in the future, and comply with legal requirements.
Information such as date, time, location, persons involved, witnesses, timeline of events, contributing factors, and recommended corrective actions must be reported on accident investigation report.
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