Accident Reporting and investigation form
This procedure guides staff through reporting and investigating a workplace accident or incident.
Accident Reporting and investigation form
This procedure documents workplace accidents and incidents, recording the date, time, code called (e.g., Code Grey, Code White, Rapid Response, Code Blue, or Code Red), and incident type such as trip, fall, slip, or medical event. It also captures the names and contact information of those involved, witnesses on site, the incident location and description, and whether EMS was called.
Date & Time
Section #7
Code Called
Section #6
Incident type
Section #3
Name persons on site (Doctor ,Nurse, Worker)
Section #4
Name of person involved in incident & contact info
Section #5
Incident location and discription
Section #6
Was EMS called
Source: Grumble Hill (Community Member)
