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DUQUESNE UNIVERSITY ACCIDENT/INCIDENT INVESTIGATION REPORT Instructions: Complete this form as soon as possible after an accident or incident. Sign and return to: Disability Claims Manager, 102K Korea
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How to fill out accidentincident investigation report

How to fill out an accident/incident investigation report:
01
Begin by gathering all relevant information about the accident or incident, including the date, time, and location of the event, as well as the names and contact information of any witnesses or involved parties.
02
Provide a detailed description of the accident or incident, including what happened leading up to the event, what occurred during the event, and any resulting damages or injuries.
03
Identify and document any contributing factors or potential causes of the accident or incident. This may include equipment malfunctions, unsafe work practices, or environmental factors.
04
Include any relevant photographs, diagrams, or other visual aids to further illustrate the scene or provide additional evidence.
05
Document any injuries or damages sustained by individuals involved, including information on medical treatment or repairs that were necessary.
06
Outline any immediate actions taken following the accident or incident to prevent further harm or mitigate damages.
07
Provide recommendations for preventing similar accidents or incidents in the future. This may involve suggesting procedural changes, equipment upgrades, or additional training for staff.
08
Review and proofread the report to ensure accuracy and clarity before submitting it to the appropriate parties.
Who needs an accident/incident investigation report:
01
Employers: Employers are required to complete accident/incident investigation reports to comply with health and safety regulations and to ensure that workplace hazards are identified and addressed.
02
Insurance companies: Insurance companies may request accident/incident investigation reports to assess liability and determine coverage for any resulting claims.
03
Regulatory bodies: Government agencies or regulatory bodies may require accident/incident investigation reports to monitor workplace safety and enforce compliance with health and safety regulations.
04
Legal authorities: In the case of serious accidents or incidents, legal authorities may request accident/incident investigation reports as part of investigations or legal proceedings.
05
Safety committees or representatives: Internal safety committees or representatives may use accident/incident investigation reports to identify trends or patterns in accidents or incidents and make recommendations for improvement.
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What is accident/incident investigation report?
An accident/incident investigation report is a document that details the findings from an investigation into an accident or incident.
Who is required to file accident/incident investigation report?
The person or organization responsible for the accident or incident is required to file the investigation report.
How to fill out accident/incident investigation report?
The report should be filled out with detailed information about the accident or incident including the date, time, location, people involved, and a description of what happened.
What is the purpose of accident/incident investigation report?
The purpose of the report is to identify the root causes of the accident or incident and to make recommendations for preventing similar events in the future.
What information must be reported on accident/incident investigation report?
Information such as date, time, location, people involved, witnesses, description of the event, contributing factors, and any recommendations for prevention.
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