Incident Report Form Template
A free incident report form for workplace accidents, injuries, and near misses. Staff report from their phone, with photos, while details are fresh.
Use templateAbout this template
Record what happened, when and where, who was involved or injured, and what was done next. Use it as a ready incident report form sample, or add questions for your workplace.
Common uses
- Workplace injuries and accidents
- Near misses and safety hazards
- Property damage and security incidents
Key features
- Photo uploads
- Signed and time stamped
- Witness details
What this template asks
What's your name?
Short Text
What's your email address?
Email
What type of incident was it?
Single Choice · Injury, Near miss, Property damage, Security, Other
When did it happen?
Date
What time did it happen?
Time · Optional
Where did it happen?
Short Text
What happened?
Long Text
Was anyone injured?
Yes / No
Who was involved or saw it happen?
Long Text · Optional
What was done right after?
Long Text · Optional
Add photos of the scene
File · Optional
Sign to confirm this report is accurate
Signature
Frequently asked questions
What should an incident report include?
What happened, the date, time, and place, who was involved or injured, any witnesses, and what was done straight after. This form asks for each of these in order.
Can staff add photos to an incident report?
Yes. Staff can add photos from their phone camera or files. Each report is signed and saved with the time it was submitted.
Can I use this incident report form sample as it is?
Yes. It covers injuries, near misses, property damage, and security incidents. Check whether your industry or regulator needs extra details, such as OSHA recordkeeping, and add them.