Incident / Accident Report
An internal record of one incident or near miss: what happened, who was involved, the underlying causes, the actions agreed and who has been told.
Free. Fill in, print, save as PDF or download as Word without an account. Saving to your account needs a free account.
Country versions
- International
- United States *
- United Kingdom *
- Korea *
- Japan *
- Germany *
* check with local advice
A template, not advice.
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What it is
An incident report is a short, factual record of something that went wrong at work, or almost did. It says what happened, when and where, who was involved, what was done straight away, why it happened and what will change so that it does not happen again. Written soon after the event, it protects the people involved, helps the next shift avoid the same trap, and gives an insurer, a landlord or an inspector a clear account if one is ever asked for.
This form covers injuries, damage, near misses, vehicle incidents, spills and security events on one sheet. People and witnesses go into tables, the causes are written without blame, and every corrective action has an owner and a date so it can be followed up. It also records one decision that is easy to forget: whether the event has to be reported to an authority or an accident insurer. The rules for that differ by country, so the form never decides it for you; the country versions only point to the rule to check. It is a general template, not legal advice.
When to use it
- Someone was hurt, even slightly, or property or equipment was damaged.
- A near miss happened that could easily have hurt someone; these reports are the cheapest warning you will get.
- A customer, visitor or contractor was involved and you want a written record the same day.
- Your insurer, landlord or client asks for an account of what happened.
- You want to follow corrective actions until each one is done.
How to fill it in
- Deal with the emergency first: first aid, emergency services, making the area safe. Fill in the form afterwards.
- Enter the date and place and tick every type of incident that applies. Record the actual outcome and the worst realistic outcome.
- Describe what happened in the order it happened, with facts only, and what was done straight away.
- List the people involved and the witnesses. Write the injury and treatment only as far as needed, and the days off if there are any.
- Tick the contributing factors and write the underlying causes. Ask why more than once and describe the way of working, not a person.
- Add corrective actions with an owner and a due date, and update their status until they are done.
- Record who has been told and whether a report to an authority or insurer is required. Then have a manager review and sign.
Common mistakes
- Writing opinions or blame into the description. "He was careless" explains nothing; "the aisle was open during put-away" does.
- Stopping at the first cause. If the answer to "why?" is one person's mistake, ask why the work made that mistake easy.
- Leaving out near misses because nobody was hurt.
- Waiting days to write it down, when the details have already faded.
- Treating this internal report as the official notification. Where a report to an authority or insurer is required, it is made on their form and by their deadline.
- Leaving health details where everyone can read them.
Steps at a glance
- Fill in
- Check the preview
- Save as PDF, Word or Excel
Country versions
Pick the country you need. Each version uses the wording and layout commonly found there; a version marked “check with local advice” should be read by someone who knows the local rules before it is used.
- International (XX): Written in English, Korean, Japanese, German
- United States (US): Written in English – check with local advice
- United Kingdom (GB): Written in English – check with local advice
- Korea (KR): Written in Korean, English – check with local advice
- Japan (JP): Written in Japanese, English – check with local advice
- Germany (DE): Written in German, English – check with local advice
Designs
The same form in several designs. The fields and the wording stay the same; only the look changes.
- Ledger
- Banner
- Executive
- Classic
- Modern
- Formal
- Minimal
- Side band
- Compact
- Boxed form
- Warm
- Plain (black and white)
Your details fill it in
Fields that ask for your name, address or company details are filled from My details, so you do not type them again; you can still change any field for one form. Signed in, your details stay in your account; otherwise they stay in this browser only. A passport, identity or social security number is never saved.
Questions
- Does this form replace the official accident report?
- No. It is your internal record. If an accident has to be reported to an authority or an insurer, use the form and the deadline that body sets. The country versions point to the rule to check.
- Which incidents must be reported to an authority?
- That depends on the country, the industry and how serious the event was. A death, a hospital stay or several days off work often trigger a duty, and some countries ask for quick notice. QuoteBill cannot decide this for you: check with your safety adviser, your insurer or the authority, then record the answer on the form.
- Should I name the person who made the mistake?
- Name the people involved as a matter of fact, but write the causes about the work: procedures, equipment, training, workload. Reports that look for blame make people stop reporting.
- How long should the report be kept?
- Retention periods differ by country and by kind of record, and the report holds personal and health data. Ask your adviser, keep it only as long as needed and limit who can read it.
- Can I use it for a near miss?
- Yes. Tick "near miss", set the outcome to "No harm" and say how serious it could have been. Near misses usually point to the same causes as real accidents, only earlier.
- Is this form legal, tax or accounting advice?
- No. It is a template: it gives you the usual structure and wording, not advice. Rules differ by country and case, so have someone qualified read anything that matters before you sign, send or file it.
- Which countries and designs does it come in?
- It comes in 6 country versions: International, United States, United Kingdom, Korea, Japan, and Germany. 12 designs.
A form is a template, not legal, tax or accounting advice. Rules differ by country and case.