FREE 6+ Accident Investigation Form Samples in PDF MS Word
Accident Investigation Form. This guidance document provides employers with a systems approach to identifying and controlling the underlying or root causes of all incidents in order to prevent their recurrence. Web this form is to be completed by the supervisor of an employee that has experienced an incident resulting in a serious injury or illness.
FREE 6+ Accident Investigation Form Samples in PDF MS Word
Make five copies of this form for any lost time injury investigations. Complete and submit this form to the designated safety office within 3 working days of the accident/incident. Notify safety specialist within 24 hours of incident(employee injury, near hit, property damage). How to conduct an incident investigation. Use to investigate a minor injury or near miss that could have resulted in a serious injury or illness.) Complete this form as soon as possible after an incident that results in serious injury or illness. Use this vehicle accident investigation report template to document information about the employee and vehicle involved in the accident. • identify documents that need to be collected. Web this form is to be completed by the supervisor of an employee that has experienced an incident resulting in a serious injury or illness. Web updated august 04, 2022.
Web updated august 04, 2022. Web accident investigation form step 1: Use to investigate a minor injury or near miss that could have resulted in a serious injury or illness.) Complete and submit this form to the designated safety office within 3 working days of the accident/incident. Injured employee (complete this part for each injured employee) name of employeedate of birth departmentoriginal hire date job title shift start time months in current job other body part injurednature of injuryarmaccident typeelbowaccident agentwristdescription of injury handfinger toes malefemale Make five copies of this form for any lost time injury investigations. It shall be completed in a timely manner following an incident, and can also be used to investigate a near miss event that could have resulted in an accident or injury. Web motor vehicle accident (crash) report. Use this vehicle accident investigation report template to document information about the employee and vehicle involved in the accident. An accident incident report is a form that asks for details about an accident that occurs in a vehicle, school, or workplace in order to properly document what took place. • identify documents that need to be collected.
