Incident Report Form

Document workplace incidents — what happened, who was involved and any injury — in one consistent, signed HR record.

Description

An incident report form gives HR a consistent, documented way to record what happens in the workplace — an accident, a safety issue, a conduct matter or a dispute. Capturing the facts properly at the time protects the people involved and the organization, and gives you a reliable record if the incident is ever revisited.

It captures the date and a description of the incident, who reported it and who was involved, and the incident type with room to specify. Whether medical attention was required with details, an upload for supporting documents, and a reporter signature complete a report you can rely on and act on.

Customize the incident types and fields to match your organization, restyle it in your brand colors, and embed it on your intranet so incidents are recorded consistently.

Form fields

Everything the Incident Report Form above collects — 10 fields, so you can see exactly what it captures before you make it your own.

Incident Report

Date of Incident
Date
Description of Incident
Long Answer
Person Reporting
Name
Person Involved
Name
Incident Type
Short Answer
Please specify incident type:
Short Answer
Was medical attention required?
Yes/No
Medical details:
Short Answer
Upload Supporting Documents
Short Answer
Reporter Signature
Short Answer

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Template FAQs

Common questions about the Incident Report Form — what it captures, when to use it, and how to make it your own.

What is a workplace incident report form?

It’s a form used to record an incident in the workplace — an accident, safety issue, conduct matter or dispute. It captures what happened, who was involved and any injury, giving HR a consistent, documented record to investigate and act on.

What does the form capture?

The date and a description of the incident, who reported it and who was involved, and the incident type with room to specify. Whether medical attention was required with details, an upload for supporting documents, and a reporter signature complete it.

When should it be completed?

As soon as possible after the incident, while accounts are accurate and memories fresh. Recording it promptly captures the facts before they’re disputed or forgotten, and gives HR a timestamped record to base any investigation or follow-up on.

Who is this form for?

HR teams, managers and health-and-safety staff, and the employees reporting incidents. It suits any organization with a duty of care that wants workplace incidents logged consistently and documented properly, rather than handled informally and forgotten.

Why record who was involved and any injury?

Who was involved and whether anyone was hurt are the details that matter most if an incident leads to a grievance, a claim or an investigation. Capturing them at the time gives you an accurate, defensible record instead of conflicting accounts pieced together later.

Is this form free to use?

Yes, it’s free. Create a Fun Forms account, customize the incident types and fields to match your organization, restyle it to your brand colors, and embed it on your intranet with no coding. Incident reports then arrive documented and ready to act on.

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