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OSHA 301 form

OSHA 301 form

The OSHA 301 form is used to record details of work-related injuries and illnesses. It helps organizations document incidents, track trends, and ensure compliance with OSHA reporting requirements. Use this form to maintain accurate records and improve workplace safety practices.

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OSHA 301 form

The OSHA 301 form is used to record details of work-related injuries and illnesses. It helps organizations document incidents, track trends, and ensure compliance with OSHA reporting requirements. Use this form to maintain accurate records and improve workplace safety practices.

Use this template with Lumiform

  • Customize this template or build your own
  • Fill out templates via mobile app
  • Get reports and analyse your data
Prices start from ░░░ per month
Book a demo
Learn more
or Download template as PDF

The OSHA 301 Injury and Illness Incident Report template helps you document workplace incidents thoroughly and accurately. This digital form captures all required information about workplace injuries, from employee details to incident specifics, ensuring you meet OSHA’s strict seven-day documentation deadline. When an employee suffers a recordable injury, you can quickly complete this form with all necessary details rather than scrambling to gather information under pressure.

According to OSHA regulations, failure to properly complete and maintain these forms can result in penalties of up to $16,550 per violation, making proper documentation not just good practice but financially essential.

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Created by

Author Name Inioluwa Ademuwagun
Preview of the template
301 Log Form
Employee Information
Full name
Address
Date of birth
Date of hired
Gender
Information about the Physician or other Health Care Professional
Name of physician or other health care professional
Was treatment given away from the worksite?
Was the employee treated in an emergency room?
Was the employee hospitalized overnight as an in-patient?
Information about the Case
Case number from the log
Date of injury or illness
Time employee began work
Estimated time of the event (leave blank if time cannot be determined)
What was the employee doing before the incident occurred? Describe the activity, as well as the tools, equipment or material the employee was using.
What happened? Tell us how the injury occurred.
Type of incident
Describe the injury or illness? Tell us the part of the body that was affected and how it was affected
What object or substance directly harmed the employee?
Upload photos of the incident
Did the employee die?
Completion
Observations and comments
Full Name of Record Keeper
Signature of Record Keeper
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Frequently asked questions

What information must be included on an OSHA 301 form?

The OSHA 301 form requires specific details about the injured employee (name, address, date of birth, hire date), the incident (date, time, location), a description of what happened, the specific injury or illness, and any treatment received. You must also document what the employee was doing before the incident and how it occurred. All fields must be accurate to maintain compliance.

How quickly do I need to complete the OSHA 301 form after an incident?

You must complete the OSHA 301 form within seven calendar days of learning about a recordable workplace injury or illness. This tight timeline makes having a ready-to-use template crucial for compliance. Even if you don’t have all details immediately, start the documentation process promptly and update as more information becomes available.

What’s the difference between the OSHA 301 form and the OSHA 300 log?

OSHA 301 is a detailed incident report for each individual workplace injury or illness, while the OSHA 300 log is a running record of all workplace injuries and illnesses throughout the year. The 301 captures specific details about what happened, while the 300 log provides a summary view of all incidents, helping identify patterns and trends.

Author
Inioluwa Ademuwagun
Inioluwa is a freelance content writer with a passion for words and everything marketing. She has worked closely with B2B SaaS and e-commerce brands creating product-led content. She loves to read fiction and would describe herself as an introverted nerd who desires to travel around the world. She currently doing that with her words till she can with her eyes
This template, developed by Lumiform employees, serves as a starting point for businesses using the Lumiform platform and is intended as a hypothetical example only. It does not replace professional advice. Companies should consult qualified professionals to assess the suitability and legality of using this template in their specific workplace or jurisdiction. Lumiform is not liable for any errors or omissions in this template or for any actions taken based on its content.