Incident Report Template

In any workplace, incidents or accidents do occur at some moment. Our Incident Report Template provides your employees with a streamlined process for reporting any incident that takes place. Use this template to ensure:

  • Incidents are reported in an efficient, structured and timely manner
  • Managers are alerted about incidents in real-time
  • Insights can be discovered quickly and your company becomes a safer place to work!

Incident report template

Incident Report Template

In any workplace, incidents or accidents do occur at some moment. Our Incident Report Template provides your employees with a streamlined process for reporting any incident that occurs. Use this template to ensure:

  • Incidents are reported in an efficient, structured and timely way
  • Managers are alerted to incidents in real-time
  • Insights are discovered quickly and your company becomes a safer place to work!

Incident report template
Sign up now to customize the Incident Report Template
To customize this template after signing up, choose ‘Incident Report’ as example when creating a new survey.
To customize this template after signing up, choose ‘Incident Report’ as example when creating a new survey.

The Importance of Incident Reporting

Workplace or employee incidents can include work-related accidents but also verbal or physical assaults, dangerous situations, vandalism, aggression, theft, unauthorized use of technology, etc. A study of the US Bureau of Labor statistics about worker injuries, illnesses and fatalities reveals that 4,836 workers were killed on the job in 2015, that is equivalent to 3.4 per 100,000 full-time equivalent workers.

In this context, recording the incident details as soon as the incident occurs is crucial. It ensures that all responsible parties are alerted in an efficient way. Over longer periods of time, incident reporting allows analysis of why the incidents happened as well as to set guidelines and policies to prevent similar incidents to occur in the future.

Why use Survey Anyplace as Incident Reporting Tool?

Quick & Easy
Fast data capture on tablets and smartphones, thanks to mobile-optimized templates
Photo Upload
Upload pictures of the incident for better understanding of what exactly happened
Automatic Alerts
Immediate awareness of responsible parties through automated email sending
Real-Time Reporting
Improve workplace security based on the insights derived from real-time reporting

Incident Report Sample

To use this sample incident report, sign up for Survey Anyplace , and choose ‘Incident Report’ as template when creating a new survey.

Incident Report Format

As can be seen in the above sample, the incident report should at least include the following information:

  • Incident reporter (person) name and department
  • Incident date & time of occurrence
  • Incident place of occurrence
  • Incident type
  • Parties involved
  • Incident description: detailed description, including pictures if relevant
  • Actions taken

It is important that the incident details can be recorded efficiently and that they are automatically transferred to a central system: Mobile devices such as a tablet or smartphone are ideally suited for it. Incident reporting through paper forms, pdf or word documents is also possible but has the disadvantage that the data still needs to be transferred to a central system as a separate action, which is error-prone and not real-time.

Looking for more survey templates and examples?

Make your company a safer place to work with our Incident Reporting Tool