FREE 5+ Workplace Accident Report Form Samples in PDF

No matter how careful we are, accidents are prone to happen one way or the other. Even when we are minding our own business, or sitting behind a desk in the office we will never know when something would occur. Some business industries are prone to accidents, like manufacturing, production, and construction companies. Accidents can be caused by human error, malfunctioning equipment, or due to natural calamities. This is why companies often need to collect information to help then create health and safety policies to make sure to avoid these from happening.

One way to collect information is to fill up a workplace accident report form. This form could be used by management to properly assess the situation and come up with ways to ensure that the company, its employees, and clients are safe. To learn more about this let us discuss this further below. And if you need to start preparing this document, check out our free workplace accident report form samples that are downloadable on this page.

5+ Workplace Accident Report Form Samples

1. Employee Accident Report Form

2. Workers Compensation Accident Report Form

3. Workplace Accident Report Form Example

4. Workplace Accident Illness Injury Report Form

5. Student Workplace Accident Report Form

6. Employee’s Workplace Accident Report Form

Workplace Accident Report Form?

A report is a form of document that is used to outline a certain topic or examine issues, events, and findings. Business organizations across the globe use a report to help them in their decision-making. So in case of an office-related emergency, reports are collected from either the witness or those who are directly involved. A workplace accident report form is a document that the person(s) concerned have to fill up so that the company has a copy of what happened and would serve as a reference or evidence. It gives the details in his/her own words and is often a good tool for corrective actions to prevent the injury from recurring. It is important that employees report immediately what had happened so the sequence of events remains fresh on their minds and that they may be able to write down a detailed report. The HR department may also use the report form as a reference to compensate the employee who has been injured during working hours or within the company premise.

How To Create a Workplace Accident Report Form?

A workplace-related accident can create a negative impact or lessen employee morale, as some may feel unsafe thinking if it could happen to their colleague then it may happen to them. This is why companies should strive to keep a safe working environment for their employees. A workplace accident report form is a good place to gather the information they may need in order to evaluate and investigate what really happened and identify the key points that can help finds ways to prevent this from happening again in the future. Or sometimes accidents can show other underlying problems that may make things more complicated.

So after the incident, or whenever the employee is available to write down a report the manager or the HR department provides the employee with a form to fill up. The document usually has a series of instructions or questions were the employee needs to answer. What do you usually find in this type of report form? Let us discuss this below.

I. Employee Information

An employee would need to supply their basic information in the form which is their name, address, date of birth, gender designation and department, current address, and contact number.

II. Accident Details

A detailed account of the accident is needed, so in the form, the usual questions or queries you would find in this section are as follows.

• Date, location and time of the accident
• Body part(s) injured or affected
• A brief explanation of what happened prior to the accident, or the events leading to the accident
• Type of material, equipment, or who has caused harm to the person concerned
• Description of the illness or injury
• Was there any medical assistance or treatment?
• Name or description of the witnesses

III. Section to be Completed by the Person in Charge

An employee must report what had happened to his or her immediate head like a manager or department head. That being said, the form must also contain a section where the manager should be able to fill up relevant information that is needed on their behalf. For example recommendation for an investigation or should the employee take the time off.

IV. Health Care Provider

Another important section needed in the form is where a health care provider, a doctor, or a company nurse for example would need to provide their diagnosis on the injured individual.

V. Authorization and Signature

Employees should affix their signature and the date of completion as a sign to authorize the company to use the information they have provided for investigation or for compensation purposes.

FAQs

It is imperative that an employee should complete a workplace accident report form, which is why companies must make sure the details written in the form is complete and easy to accomplish. To make it easier for you to prepare one, download our free templates now!