Incident Report Form

An incident gets written down badly because it gets written down late. This form is built to be filled in on a phone while somebody is still standing where it happened: the date and the time, the address, the type, and a plain account of what occurred, in that order. The time field is separate from the date on purpose, because a report that says only which day it was cannot be matched against a shift pattern or a camera recording.

The severity question does the triage. Four options separate a near miss logged for the record from an incident that stopped work, which is the difference between a monthly summary and something a manager reads today. Underneath it, the response checkboxes capture what was actually done at the time, so the gap between the event and the first action is visible rather than argued about later.

Everything after the account is evidence and accountability. The upload field takes photographs while the scene still looks the way it did, the witness box catches names that are forgotten within hours, and the declaration plus signature turn the whole thing into a record somebody has put their name to.

Adapt the type and severity lists to your own categories, since every safety policy words them differently. Sites that need a supervisor to countersign can add a second signature field at the end, and anyone reporting on behalf of a contractor usually wants a company name next to the reporter details.