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OSHA incident report form

OSHA incident report form

Download our essential OSHA incident report form template to meticulously document workplace incidents. Ensure your reports are thorough, compliant, and enhance overall safety.

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  • Customize this template or build your own
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  • Get reports and analyse your data
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or Download template as PDF
OSHA incident report form

Download our essential OSHA incident report form template to meticulously document workplace incidents. Ensure your reports are thorough, compliant, and enhance overall safety.

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

Meet your OSHA reporting obligations with the help of this incident report form for documenting workplace injuries, illnesses, and near misses thoroughly. Beyond basic compliance, this template guides you through proper incident investigation so you can identify root causes and implement preventive measures. For example, if a warehouse employee reports back strain from improper lifting, you can document not just the injury but also the underlying safety training gaps.

Research points out that effective incident reporting starts with clearly defining what constitutes a reportable event and providing quality examples as reference points. This template gives you the structure to transform incident documentation into a valuable safety improvement tool.

Related categories

  • Health and safety management templates
  • General templates
  • Incident management templates
  • Workplace safety templates

Created by

Author Name Nicky Liedtke
Preview of the template
Page 1
Incident Details
Date of Incident
Describe Incident
Injured/Affected Employees
Name of Injured/Affected Employee
Job Title
Part of Body Affected
Nature of Injury/Illness
Did Employee Receive Medical Treatment?
Was Employee Hospitalized Overnight as an In-patient?
Incident Investigation
What was the employee doing just before the incident occurred?
What went wrong?
Why did the incident occur?
What has been done to prevent recurrence?
Reporting and Review
Date Report Completed
Supervisor Review
Management Review

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Related resources

Access a complete set of resources aimed at maximizing safety, quality, and operational excellence, including detailed guides, related templates, and real-world use cases.

Topic guides

Read in-depth guides covering key topics related to this article.

OSHA regulations: A compliance guide for professionalsHow to write an incident report: Your complete guideIncident management: A deep dive
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Template collections

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OSHA compliance softwareIncident report softwareIncident management softwareSafety Incident Reporting Software
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Other resources

Explore all the additional resources we offer to assist you in mastering this topic.

OSHA: Fatal four construction hazards5 types of incident reportsHow to implement operational excellence4 benefits of safety management and how to communicate them

Frequently asked questions

How do I properly document injuries in the form?

Describe the injury specifically, noting both the type of injury (laceration, fracture, strain) and its severity. Avoid vague terms like “hurt” or “injured” in favor of precise medical terminology when available. This specificity helps track injury patterns over time and supports appropriate medical response and workers’ compensation claims.

Who needs to review and approve my completed incident report form?

Typically, the immediate supervisor should review the report first, followed by safety personnel and appropriate management. The approval chain ensures accuracy, completeness, and appropriate corrective actions. Some organizations also involve their safety committee in reviewing reports to provide additional perspectives and ensure accountability for follow-up actions.

How do I document near misses using this OSHA incident report template?

Complete the form as you would for an actual incident, but indicate “near miss” in the description. Focus especially on what could have happened and why it didn’t. Near miss documentation is invaluable for prevention, as these events often share causes with actual incidents but provide learning opportunities without the harm.

Author
Nicky Liedtke
Nicky is a content writer and researcher for Lumiform. With her content writing and copywriting experience, she creates high-quality content across a variety of relevant topics. She aims to promote workplace safety, sustainable operational excellence, and continuous improvement in her articles. She is passionate about communicating how technology can be used to have a positive impact on the environment and helping organizations reduce paper waste and achieve their business goals.
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.
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