Get the free Incident Report Form - College of Physicians and Surgeons of ... - cpsbc

NON-HOSPITAL MEDICAL AND SURGICAL FACILITIES PROGRAM College of Physicians and Surgeons of British Columbia 300-669 Howe Street Vancouver BC V6C 0B4 www.cpsbc.ca Telephone: 604-733-7758 Toll Free:

How to fill out incident report form

How to fill out an incident report form:

Begin by filling in your personal information, including your name, contact information, and job title. This will help identify who is submitting the report.

Provide details about the incident:

1. Describe the nature of the incident clearly and concisely. Include information such as the date, time, and location of the incident.
2. Identify any witnesses present during the incident. It's important to gather their contact information as well.
3. Explain what actions were taken immediately following the incident, such as notifying a supervisor or seeking medical attention.

Include a detailed account of what occurred:

1. Write a chronological narrative of the events leading up to and following the incident. Be as specific as possible and use objective language.
2. Include any relevant information about the individuals involved, such as their names, job titles, and roles during the incident.

Document any injuries or damages:

1. If there were any injuries, describe them in detail, including the type and extent of injuries, and whether medical treatment was provided.
2. Record any damage to property or equipment and their estimated value.

Provide additional information:

1. Include any photographs, videos, or other supporting documentation related to the incident, if possible.
2. If there were any mitigating factors or recommendations for preventing similar incidents in the future, include them in this section.

Who needs an incident report form?

1. Employers: In order to comply with legal requirements and ensure workplace safety, employers need incident report forms to document and investigate any accidents or incidents that occur within their organization.
2. Employees: Employees who have been involved in an incident, witnessed an incident, or observed an unsafe situation should fill out an incident report form to report the details accurately and promptly.
3. Authorities: Incident report forms may be required by regulatory agencies, insurance companies, or legal authorities to properly investigate incidents, determine liability, or process claims.

Overall, anyone who is involved in or witnesses an incident should fill out an incident report form to ensure accurate documentation, investigation, and appropriate actions can be taken.

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