Pennsylvania Hazard and Incident Report Form

State:
Multi-State
Control #:
US-435EM
Format:
Word; 
Rich Text
Instant download

Description

This form is used to report all work-related hazards and incidents.

How to fill out Hazard And Incident Report Form?

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FAQ

A Hazard Report is designed to help employees draw attention to current and potential hazards in the workplace. Depending on the nature of the business, and the role of the employee, there is a vast range of use cases where hazard reports can be used.

An incident report is a tool that documents any event that may or may not have caused injuries to a person or damage to a company asset. It is used to capture injuries and accidents, near misses, property and equipment damage, health and safety issues, security breaches and misconducts in the worksite.

Common Types of Incident ReportsWorkplace. Workplace incident reports detail physical events that happen at work and affect an employee's productivity.Accident or First Aid.Safety and Security.Exposure Incident Report.

Generally, you are obligated to complete an incident report form for every incident however minor, and keep a record of every workplace accident (called a 'Register of Injuries' in NSW). At a minimum, this must be available at all times, and each report should contain the following information: Name of injured worker/s.

'Hazard': an object or situation that has the potential to harm a person, the environment or cause damage to property. 'Incident': any unplanned event resulting in, or having a potential for injury, ill health, damage or other loss. 'Injury': any physical or mental damage to the body caused by exposure to a hazard.

'Hazard': an object or situation that has the potential to harm a person, the environment or cause damage to property. 'Incident': any unplanned event resulting in, or having a potential for injury, ill health, damage or other loss.

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.

The location of the incident; Conditions at the scene such as temperature, light, noise, weather; A summary of events leading up to the injury/illness, the task that the worker was performing when the incident occurred; Root causes of the incident.

3 Types of Incidents You Must Be Prepared to Deal WithMajor Incidents. Large-scale incidents may not come up too often, but when they do hit, organizations need to be prepared to deal with them quickly and efficiently.Repetitive Incidents.Complex Incidents.

Incident reporting is the process of recording worksite events, including near misses, injuries, and accidents. It entails documenting all the facts related to incidents in the workplace. Incidents are generally accidents or events that cause injuries to workers or damages to property or equipment.

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Pennsylvania Hazard and Incident Report Form