Workplace Incident Report Form
An incident is easier to follow up when the time, the place, and what happened are written once. This workplace incident report form asks who is reporting, when and where it happened, who was involved, what happened, whether anyone was hurt, witnesses, photos, what was done next, and a signature. It does not decide fault. Edit the wording, try it, then send one link when something needs a record.
Last reviewed November 2, 2026 by FormSign team.
Edit it, try it, then create an account to save and share.
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Questions in this template
Reporter
- Your name (required)
What happened
- Date and time (required)
- Location (required)
- People involved (required)
- What happened (required)A short description. Skip medical detail.
- Anyone hurt (required)Yes · No · Not sure
- Witnesses
Follow-up
- PhotosOptional. A photo of the scene.
- Action taken
Signature
- Signature (required)
- Date (required)
What is a workplace incident report form?
A workplace incident report form is the note of what was reported: when, where, who was there, what happened, and whether anyone was hurt. It does not decide fault.
When to use it
- When something happens at work and you want the same questions each time.
- When photos should sit on the same row as the description.
- When the person reporting should sign the note.
- When several reports come in during the same week.
What to include
Who is reporting
Name.
When and where
Date and time, and location.
What happened
People involved, a short description, whether anyone was hurt, and witnesses.
What you did next
Photos, the action taken, and a signature.
Why FormSign
Each report becomes a row on your FormSign board, with photos on that row. The starter letter uses each question's label as a placeholder, so a copy of the report matches the form.
This template is a starting point, not legal advice. It records what was reported. It does not decide fault.
Questions
Does this form decide who was at fault?
No. It records what was reported. Decisions stay in your usual process.
How much detail belongs in what happened?
A short description of the event. Do not add a medical history or a diagnosis.
What if nobody was hurt?
Choose No for anyone hurt, and still describe what happened.
Can they attach more than one photo?
The template has one photo upload. Duplicate that question in the builder if a report needs several files.
Do I need an account to try it?
No. Open the template, edit the questions and test it. You'll create an account when you want to save it and send it.
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Build for free. Pay once a workflow goes live at 10 submissions or 2 documents sent for signature.