Accident Report Form Template

When filling out an accident report form, you’ll need to gather essential details about the incident, such as date and time, the affected individuals, and the type of accident that occurred.

There are 6 elements that you must include within an accident report form:

1. Type of incident: Include the type of incident and the accident class in the report form.
2. Address: The location of the incident.
3. Date and time of the incident: if exact timing is unknown, provide a range.
4. Name of affected individual: Provide details of the affected person and any witnesses.
5. Description of the incident: Include a succinct but detailed statement describing the events that led to the incident. You can include the type of work at the time of the event, any hazards involved, any personal protective equipment (PPE) used, and the license plate if a vehicle was involved.
6. Signature: Include the full name and signature of the person for company records. You can use our e-signature field to provide a legally binding signature from any location.

There are 4 types of accident report forms:

1. Near Miss: A near miss report is where there was no personal injury, but someone could have been hurt. It's essential to note any safety issues and report such events to help management take corrective action. Injury or lost time: this kind of report documents non-life-threatening injury. It’s essential to report whether or not you wore PPE, followed procedure, or if other variables came into play - even if they seem minor.
2. Exposure Incident Report: This report is used when someone may have been exposed to harmful substances. Safety professionals must report and record such incidents to prevent future harm in similar incidents and for insurance companies.
3. Sentinel Event Report: Sentinel events reports are used in extreme cases where events have resulted in a death or severe and permanent injury, and the police department or any law enforcement agencies may need to be notified.

While often used interchangeably, there are a few critical differences between an incident and an accident report. An accident is an event that has unintentionally happened that results in damage, injury, or harm. On the other hand, an incident is an event that didn't necessarily result in harm but could have.

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