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EMPLOYEE HAZARD and/or INCIDENT REPORT FORM DIRECTIONS: This form is for employees to report any hazard, near miss work incident or voluntary reporting of an offthejob incident. Any work incident

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How to fill out employee hazard and/or incident:

1. Gather all necessary information: Start by gathering all the relevant details about the hazard or incident that occurred. This may include the date, time, location, and a description of what happened.
2. Identify the individuals involved: Make sure to note down the names and job positions of any employees who were directly or indirectly affected by the incident. This could also include witnesses or others who may have pertinent information.
3. Document the circumstances: Provide a detailed account of how the hazard or incident occurred. Include any factors that may have contributed to the situation, such as equipment failure, unsafe conditions, or employee behavior.
4. Assess the consequences: Describe the impact that the hazard or incident had on the employees involved, whether it caused any injuries, illnesses, or damage. This will help in determining the severity and urgency of the situation.
5. Take corrective actions: Outline the steps that were taken immediately after the incident to mitigate any risks or prevent further occurrences. Include any first aid administered, medical attention sought, or adjustments made to the working environment.
6. Preventive measures: Suggest and implement recommendations for preventing similar incidents in the future. This may involve improving safety protocols, conducting employee training, or implementing new equipment or procedures.

Who needs employee hazard and/or incident:

1. Employers: Employers have a legal and ethical responsibility to ensure the safety and well-being of their employees. They need to be aware of any hazards or incidents that occur in the workplace, assess the risks involved, and take appropriate actions to prevent future occurrences.
2. Human Resources (HR) department: The HR department is responsible for managing employee relations and ensuring compliance with workplace safety regulations. They need to have access to information about hazards and incidents to fulfill their duties effectively and provide necessary support to the employees involved.
3. Health and Safety Committees: These committees, consisting of representatives from both management and employees, play a crucial role in identifying, evaluating, and addressing workplace hazards. They need access to information about hazards and incidents to carry out their responsibilities and make informed decisions regarding safety measures.
4. Employees: Employees themselves should be aware of the hazards and incidents that occur in their workplace. By reporting these incidents and hazards, they contribute to creating a safer work environment for themselves and their colleagues. It also helps them stay informed about potential risks and actively participate in preventive measures.

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