Accident, Incident & Near-Miss Report Form
An incident report template — what happened, who was affected and the action taken, with RIDDOR check and sign-off.
Description
Form fields
Everything the Accident, Incident & Near-Miss Report Form above collects — 10 fields, so you can see exactly what it captures before you make it your own.
Accident, Incident & Near-Miss Report
What are you reporting?
Dropdown
Date it happened
Date
Time it happened
Time
Where did it happen?
Short Answer
Who was involved or affected?
Short Answer
What happened? Describe clearly
Long Answer
Injury (if any) and first aid / action taken
Long Answer
Is this reportable under RIDDOR?
Yes/No
Reported by
Short Answer
Signature
Signature
No credit card
Unlimited forms
Unlimited results
Template FAQs
Common questions about the Accident, Incident & Near-Miss Report Form — what it captures, when to use it, and how to make it your own.
What should I report?
Any accident or injury, near miss, equipment or gas incident, or food safety incident. Recording even minor ones builds a picture and shows you manage safety.
What's the RIDDOR prompt for?
Certain workplace injuries and dangerous occurrences must be reported to the HSE under RIDDOR. The form prompts you to consider whether this one qualifies.
Why record near misses too?
Because a near miss is a warning. Recording it lets you fix the cause before it becomes an actual accident.
What detail should I capture?
What happened, when and where, who was affected, any injury and the first aid or action taken — clearly and at the time, while it’s fresh.
Why sign the report?
A signed, dated record is stronger evidence and makes clear who reported it and when.
Is the template free?
Yes — free with a Fun Forms account and fully brandable.
No credit card
Unlimited forms
Unlimited results







