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F OH&S 18 Forms for Occupation Health and Safety INCIDENT WITNESS STATEMENT FORM Name: (Please Print) Witness Information Worksite Description: Address: City, Province: Postal Code: Contact Number:.

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How to fill out the Incident Statement Template online

Filling out the Incident Statement Template online is a straightforward process that allows witnesses to provide crucial information regarding workplace incidents. This guide will walk you through each step necessary to complete the template effectively.

Follow the steps to complete the Incident Statement Template online.

  1. Press the ‘Get Form’ button to access the template and open it in the online editor.
  2. Begin filling out the 'Name' field by printing your name clearly as it should appear in the document.
  3. Provide your 'Witness Information' by completing the 'Worksite Description', 'Address', 'City, Province', and 'Postal Code' sections accurately.
  4. Enter your 'Contact Number' to ensure that you can be reached if further clarification is required.
  5. Record the 'Date and Time of Incident' in the specified format (MM, DD, YYYY) and designate whether it occurred in the 'am' or 'pm' section.
  6. Detail the 'Location' of the incident, being as specific as possible to provide a clear understanding of where the event took place.
  7. Indicate the 'Type of Incident/Injury' by selecting the appropriate categories from the provided options, such as 'Injury/Illness', 'Fire', or 'Spill'.
  8. Utilize the space provided to describe your observations of the incident in detail, including contributing factors leading up to the event. It’s important to be thorough and precise.
  9. Once you have completed all sections of the template, review your information for accuracy and completeness.
  10. Finally, you can save changes, download, print, or share the completed form as necessary.

Complete your Incident Statement Template online today to contribute to workplace safety.

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Incident reports include all of the facts related to the incident, such as the contact information of the people involved; a description of the incident itself; and any follow-up actions that were taken, like medical treatment.

What should you include in an incident report? When & where did it happen? Your report should contain the date, time and location where the accident took place. ... Who were involved? ... What did they do? ... Why did it happen? ... Were there any witnesses? ... What is the extent of damage to a person or property?

A concise but complete description of the incident Include details about what happened before the incident, the incident itself, and actions that were taken immediately after. If you are writing down your opinion of what caused the incident or what you think happened, be sure to note that it is an assumption.

Incident Report Sample Walkthrough: A Step-by-Step Guide Step 1: Provide Fundamental Information. ... Step 2: Take Note of Any Damages and Injuries. ... Step 3: Identify Affected Individual(s) ... Step 4: Identify Witnesses and Take Their Statements. ... Step 5: Take Action. ... Step 6: Close Your Report.

An incident statement specifies the details of the incident and describes what actually happened. Incident Statement form templates help you to make the forms required to take down the incident statement.

Writing a statement A written statement should be presented in typed form. ... Stick to the facts and try not to insert your opinions. Be descriptive and detailed when discussing the event and include: ... Be concise in your writing and only include relevant information.

Incident can refer to any event – big or small, good or bad, intentional or unintentional. A bank robbery, a funny or controversial situation, an argument between celebrities, etc. – all can be described as incidents.

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