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Click ‘Get Form’ to open the ACCIDENT / INCIDENT INVESTIGATION FORM - tru in the editor.
Begin by filling out the 'EVENT INFORMATION' section. Enter the date the investigation started, type of investigation, and its status. Specify the location and provide details about the incident, including names of witnesses and whether statements or pictures are attached.
In section B, provide information about the injured or ill person. Fill in their last name, first name, position reported to, employee number, and service years. Document their account of the incident and ensure they sign where indicated.
Proceed to section C for property damage details. List all damages along with estimated costs and downtime hours.
Complete sections D through J by detailing environmental impacts, direct causes of the incident, hazard evaluations, corrective actions taken, and signatures from involved parties.
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An incident investigation is an official review or examination of an unplanned event, whether major or minor, which may lead to an accident or a loss of time, property, health, or an individuals life.
What is the purpose of an incident report form?
The reason the two terms confuse people is due to the fact theyre regularly used interchangeably. But they shouldnt be. The main difference between accident and incident is the former does result in personal injury or property damage. While the latter doesnt result in personal injury.
What is an accident incident report form?
In a health care facility, such as a hospital, nursing home, or assisted living, an incident report or accident report is a form that is filled out in order to record details of an unusual event that occurs at the facility, such as an injury to a patient.
What is the purpose of an accident investigation form?
Most importantly, it enables employers and workers to identify and implement the corrective actions necessary to prevent future incidents.
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INCIDENT/ACCIDENT INVESTIGATION FORM. Complete a file copy and submit a copy to the local Extension office after each incident. Copy should also go to County
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