Follow the steps to successfully complete your incident report.

1. Click ‘Get Form’ button to access the incident report and open it in your online editor.
2. Complete the employee information section by providing your name, employee number, department or job title, hire date, and employment status. Make sure all entries are accurate to avoid any delays in processing.
3. Record the date and time of the incident, including whether it was in the AM or PM. Enter your date of birth for identification purposes.
4. Describe the location and environment of the incident. Be specific about whether the setting was indoors or outdoors and detail any weather conditions or lighting issues.
5. Identify the body part(s) that were injured and provide a detailed description of what occurred. Use additional sheets if necessary to explain the events clearly.
6. Indicate any actions taken to remedy the injury, such as applying ice, heat, or other first aid measures.
7. Answer whether you reported the incident to your supervisor immediately afterwards, and if not, provide an explanation for the delay.
8. Indicate whether personal protective equipment (PPE) was used during the incident and specify what type.
9. Indicate if you had received training for the task you were performing and when that training took place.
10. Detail any tools or equipment you were using at the time of the incident, including any relevant identification numbers for vehicles or equipment.
11. Complete the payroll information section, checking all applicable shift hours and other relevant details about your work schedule.
12. In the medical information section, specify whether you have seen a doctor for the injury, and if applicable, describe any work restrictions that were prescribed. Include the name of the physician or hospital if relevant.
13. State if you missed time from work due to the injury, noting the last date worked and when you returned.
14. If there were other people present during the incident, provide their names and describe their involvement. Also, confirm if other employees were injured.
15. Include any additional remarks or recommendations for preventing similar incidents in the future.
16. Finally, ensure all necessary signatures are obtained from both you and your supervisor, and check that your form is complete before saving, downloading, printing, or sharing as needed.

Complete your incident report online today to ensure your safety and compliance with workplace policies.