Table of Contents
- Incident Details
- Injury Information
- Incident Type
- Incident Description
- Immediate Causes
- Root Causes
- Corrections
- Corrective Actions
- Report Approval
- Download Sample Incident Investigation Report Template
Incident Details
The report should begin with basic information about the incident, including:- Incident number
- Incident date and time
- Report date
- Location of the incident
Injury Information
If the incident involved an injury, the following details should be included:- Name of the injured person
- Supervisor’s name
- Number of days lost (as per medical report)
Incident Type
The report should clearly indicate the type of incident. Common categories include:- Fire / Explosion
- Road Traffic Accident
- Property Damage Case
- Near Miss
- Dangerous Occurrence
- Various injury classifications (e.g., First Aid Case, Medical Treatment Case, Lost Time Injury)
Incident Description
A detailed account of the incident should be provided, including relevant documents such as witness statements, supervisor statements, and photographs.Immediate Causes
This section should outline the direct reasons that led to the incident. Multiple causes may be identified, such as:- Failure to wear PPE
- Using defective tools or equipment
- Inadequate guards or barriers
- Poor housekeeping
- Working without a permit
Root Causes
The report should identify the underlying factors that allowed the incident to occur. Examples include:- Insufficient or incompetent supervision
- Inadequate training or procedures
- Lack of maintenance
- Ineffective hazard identification
- Lack of discipline or motivation
Corrections
This section should detail the immediate actions taken to rectify the situation following the incident.Corrective Actions
Long-term measures to prevent the recurrence of similar incidents should be outlined in this section.Report Approval
The report should include fields for:- Name and signature of the person who prepared the report
- Name and signature of the person who reviewed and approved the report
- Dates of preparation and approval
Download Sample Incident Investigation Report Template
To access a sample Incident Investigation Report template and enhance your organization’s safety documentation process, subscribe to HSENation.com. Our comprehensive resources will help you maintain best practices in health, safety, and environmental management.Premium Content. Download of HSE Document is Available Only For Subscribers
Please subscribe to unlock the download link & Get full access to all AI Tools, Download Safety Signs, Safety Posters, Safety Talks, HSE Documents & HSE Trainings.
Subscribe to unlock
Join the community trusted by HSE pros worldwide!
