Incident report template

A structured way to record what happened, when and who was involved.

How to use itFill it in as soon as it is safe to do so, stick to facts and keep a copy in a secure place.

Basic facts

What happened

Follow-up

Tips for using this template well

  1. Record facts, not opinions.
  2. Complete it promptly.
  3. Store it securely and limit access.
  4. Review reports for patterns.

Write facts, not conclusions

An incident report should say what the writer saw and did, in time order. “The floor was wet near the walk-in at 2:10 p.m. and Sam slipped” is a fact. “Sam was careless” is an opinion and does not belong. Record names of witnesses, the exact location, the condition of the area and what was done next. Sign and date the report the same day while memory is fresh.

When an injury must be reported

In the United States, employers covered by OSHA must report a work-related fatality within 8 hours, and an inpatient hospitalization, amputation or loss of an eye within 24 hours. Many employers with more than ten employees must also record certain injuries on a log. Workers’ compensation claims have their own deadlines that vary by state, so tell your insurer promptly.

How it shows up in scheduling

After an incident, the schedule may need to change: an injured employee is off duty, a witness is interviewed, the area is closed. Note the date and hours lost, so payroll and workers’ compensation records agree with the report.

Common mistakes

OSHA forms and deadlines

An internal incident report is often the source for OSHA’s injury records. Employers covered by the recordkeeping rule must enter a recordable injury or illness on the OSHA 300 Log and complete a Form 301 or an equivalent report within 7 calendar days of learning about it (29 CFR 1904.29). A case is recordable when it leads to days away, restricted work, medical treatment beyond first aid, loss of consciousness or another listed outcome. The yearly summary, Form 300A, is posted from February 1 to April 30, and the forms are kept for five years. Employers with ten or fewer employees in the whole company, and those in certain low-hazard industries, are partly exempt from keeping the log, but every employer must report severe injuries.

Electronic submission

Some establishments must also send their data to OSHA online by March 2 each year. Establishments with 20 to 249 employees in designated industries submit Form 300A data, and since 2024 establishments with 100 or more employees in certain high-hazard industries also submit Forms 300 and 301. OSHA’s Injury Tracking Application lists who must file.

A completed report

Sample report (fictional)
Field Entry
When and where Tuesday 2:10 p.m., stockroom by the walk-in cooler
Who Sam T., prep cook; witness: Ana R., dishwasher
What happened Sam slipped on water from the cooler door gasket and landed on his left wrist
Injury and care Wrist swollen; first aid on site, then urgent care; X-ray negative, wrist splint
Immediate action Area dried and coned; cooler door reported to maintenance
Prevention Gasket replaced Wednesday; floor mat added; checked in weekly walk
Recordable? Splint for immobilization is beyond first aid, so yes; entered on the 300 Log

The report states facts in order, names the witness and links the cause to a fix.

After the report is filed

  1. Tell your workers’ compensation insurer.
  2. Decide whether the case is recordable and log it.
  3. Fix the cause and check the fix within a week.
  4. Share the lesson with the team without naming the injured person.

Incident report: common questions

Is a report always required?

Rules differ. Ask a qualified professional.

Who should keep it?

Per your retention policy.

Who should write the report?

The person who saw it or the supervisor on duty. Witnesses can add their own statements.

Do I report near misses?

It is good practice. A near miss is a free warning about a hazard before someone gets hurt.

Should employees get a copy?

Many employers give the employee a copy on request. Follow your policy and the law.

Is first aid alone recordable?

No. Cases treated only with first aid as defined in 29 CFR 1904.7, such as bandages, ice or non-prescription medicine at non-prescription strength, are not recordable.

Where to go next

Related reading

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Disclaimer: This template is general information to adapt to your own business. It is not legal, safety or compliance advice, and it does not replace requirements set by law or your insurer. Check local rules with a qualified professional.