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Accident Investigation Form

This accident investigation report form collects key details about workplace accidents including the date, those involved, the job being done, time of occurrence, cause of the incident, level of injury, and distributions to management, health and safety, and quality assurance personnel. The form gathers essential facts like the nature of the incident, permits or risk assessments used, and classification of any injuries to understand what happened and how to prevent future accidents.

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30 views1 page

Accident Investigation Form

This accident investigation report form collects key details about workplace accidents including the date, those involved, the job being done, time of occurrence, cause of the incident, level of injury, and distributions to management, health and safety, and quality assurance personnel. The form gathers essential facts like the nature of the incident, permits or risk assessments used, and classification of any injuries to understand what happened and how to prevent future accidents.

Uploaded by

ikponmwonsa
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOC, PDF, TXT or read online on Scribd
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DOL-F-008

Accident Investigation Report Form

Accident/Incident Date of Occurrence


no:
`
Date of Investigation

Nature of Incident

Who were involved

What job was being done

What time did it occur


Any permit to work
Risk assessment form for job approval
What is the cause of the incident

What is the class of injury suffered Minor Major Fatal

Any LFI

Distributions :
MD
QA/QC
HSE

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