Hawaii Accident - Injury Report

State:
Multi-State
Control #:
US-429EM
Format:
Word; 
Rich Text
Instant download
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Public form

Description

This form is used to document accidents and/or work-related injuries.

How to fill out Accident - Injury Report?

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FAQ

Complete an incident report Include an explanation of what occurred and the damages caused, witness testimonies, contact information of all involved parties, pictures of the area, and any other relevant information. These reports become invaluable if the victim decides to take legal action against your organization.

How Do I Report an Accident at Work?Step 1: Check there is no immediate risk of danger.Step 2: Ensure that the colleague receives the appropriate medical assistance as necessary.Step 3: Report to a manager or supervisor.Step 4: Record the incident in the company's log.Step 5: Report the incident under RIDDOR.More items...?

8 Items to Include in Incident ReportsThe time and date the incident occurred.Where the incident occurred.A concise but complete description of the incident.A description of the damages that resulted.The names and contact information of all involved parties and witnesses.Pictures of the area and any property damage.More items...?

Provide the basic facts. If not, start the report with a sentence clearly stating the following basic information: The time, date and location of the incident (be specific; write the exact street address, etc.). Your name and ID number. Names of other members of your organization who were present.

When & How to Document Workplace InjuryGet to the site as quickly as possible.Ensure the area is safe to enter.Make sure the injured/ill person is receiving first-aid or medical attention.Identify any witnesses.Record the scene with photos (ideally with date and time stamp) or sketches.Safeguard any evidence.More items...

When it comes to filling out an accident report form, you would need to ensure the following information: The injured party's contact details which must include their full name, address and telephone number as well as their email address, gender and date of birth.

Keep in mind that these 3 considerations are not to be confused with the 3 requirements for writing an incident report:The report must be factual and without assumption.An incident report must be accurate and without bias.The incident report must be complete.

Injury and Lost Time Incident Report SampleType of incident (injury, near miss, property damage, or theft)Location (Address)Date/time of incident.Name.Name of supervisor.Description of the incident, including specific job site location, the sequence of events, and the results of the event.More items...?

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Hawaii Accident - Injury Report