Accident report form: what to record, with a free template

What an accident report form is for

It is your own record of something that went wrong: an injury, a near miss, a dangerous occurrence or damage to property. Some firms call it an incident report form. It is the same document, and one form can serve for all of them.

It is easy to mix it up with two other things, so it helps to set them side by side.

A well-filled report form gives you everything you need for the other two. Our guides to the accident book and RIDDOR reporting cover those duties in full.

What the law says must be recorded

No regulation sets out an accident report form. Two sets of regulations list details that have to be on record.

• For the accident book, Schedule 4 of the Social Security (Claims and Payments) Regulations 1979 requires the injured person's full name, address and occupation; the date and time; the place; the cause and nature of the injury; and the name, address and occupation of the person making the entry if it is someone else.
• For RIDDOR, Schedule 1 of the 2013 Regulations requires, for every reportable incident and every over-three-day injury, the date and time, the injured person's full name, occupation and injury, the place, and a brief description of the circumstances. For a member of the public it asks for their status, such as customer or visitor, in place of their occupation. If the incident was reported, the record must also show the date and the method of reporting.

Both sets of records must be kept for at least three years.

The form on this page holds the details that both ask for, including the injured person's home address and the name, address and occupation of whoever filled it in. If you go on to report the incident, section 8 has a box for the date, how you reported it and HSE's reference, or you can keep the copy of the report that HSE lets you download. Because a completed form carries a home address and details of an injury, keep it somewhere secure.

The form, section by section

About the person affected

Full name, job, and whether they are an employee, a contractor or a visitor. That last box matters more than it looks: the RIDDOR rules are different for people who are not at work, and for a contractor's employee it may be their employer who has to report. If nobody was hurt, write "no one injured" and carry on.

When and where

The date, the time as near as anyone can say, and the exact location. "Warehouse" is not a location. "Aisle 4, bay 12, by the roller door" is. Someone who was not there should be able to walk to the spot.

What happened

A description of the event, what the person was doing at the time and any equipment involved. Name the equipment precisely: the make and the fleet or asset number if it has one. This is the box most often filled in badly, and there is a worked example below.

Injury and treatment

The injury, the part of the body and which side, the first aid given and who gave it, whether the person went to hospital, and any time off. Leave the time-off box open and come back to it. An injury that looks minor on Monday can become an over-seven-day injury by the following week, and that changes what you have to do.

Witnesses

Names and how to contact them, including people who did not see the event but saw the scene straight after. Ask each one for a short account in their own words on the same day.

Immediate actions taken

What was done there and then to make the area safe: machine isolated, spill cleaned up, area coned off, ladder taken out of use. This shows that the danger was dealt with before work carried on.

Cause, and what will be done to stop it happening again

The form asks for the cause, then for each action: what, who and by when. Look past the first answer. "He slipped" is what happened. "The gutter above the doorway leaks on to the step and has done for months" is a cause you can fix. An action with no name and no date against it will not get done.

Reported by and date

Who filled the form in and when. A form completed on the day carries more weight than one written up three weeks later, and the date shows which it was.

RIDDOR reportable? Yes, no, or to be checked

The person filling in the form on site may not know the rules. "To be checked" lets them hand the question on, as long as someone picks it up that day. The clock for a RIDDOR report starts at the incident, not when the form reaches the office.

What a good description looks like

Here is the same accident written twice.

Weak: "Cut hand on saw. First aid given. Told to be more careful."

Strong: "At about 10.40 Dean was clearing an offcut from the bed of the panel saw in the main workshop. He had pressed stop, but the blade was still running down. As he reached across, the back of his left hand touched the blade. Cut about 3 cm long across the knuckle of the left index finger. Top guard and riving knife were in place. He was wearing safety glasses and no gloves. Sam Hughes, first aider, cleaned and dressed the cut at 10.45. Dean returned to work on the bench, not the saw."

The second version can be acted on. It tells you the saw has no brake or the run-down time is long, that offcuts are being cleared by hand, and that nobody is using a push stick. The first tells you nothing except that someone was blamed.

What makes the difference:

• Write what was seen, not what is assumed. "The floor was wet" is a fact. "He was not looking where he was going" is an opinion.
• Put events in order. What the person was doing, what changed, what happened next.
• Be specific about the body. Left or right, which finger, how big.
• Record the conditions. Lighting, weather, floor surface, noise, whether guards and PPE were in use.
• Leave out blame. The form is there to find the cause. People stop reporting when reports are used against them.
• Take photographs before anything is moved, if it is safe to do so, and note on the form that you have them.

Who fills it in, and when

The supervisor or manager on the spot, with the injured person if they are able, on the same day. Memory fades fast and the scene changes: the spill is mopped, the pallet is moved, the shift goes home.

If you are required to keep an accident book, remember that the law gives the injured employee, or someone acting for them, the right to make the entry themselves. Your form does not replace that unless employees can get an entry made on it readily.

What to do with the form afterwards

1. Decide whether it is reportable under RIDDOR. A death, a specified injury such as a fracture, or a member of the public taken to hospital must be notified without delay and reported within 10 days. An injury that keeps a worker from their normal work for more than seven days must be reported within 15 days of the accident.
2. Follow up the time off. Check after three days and again after seven. More than three days must be on record. More than seven must be reported.
3. Investigate. Where an employee has given you notice of an accident, social security law requires you to take reasonable steps to investigate it. HSE's guidance goes further and says you should investigate accidents and near misses as part of checking that your controls work.
4. Do the actions and write on the form when each one was finished.
5. Look at the risk assessment for that job. HSE's guidance is to consider a review when there has been an accident or a near miss.
6. Tell your insurer if a claim is possible. HSE does not pass RIDDOR reports to insurers.
7. File it securely. The form holds personal and health details, so keep it where only those who need it can read it, for at least three years.

Recording incidents in SafetyPro360

SafetyPro360 holds the same record as this form. An incident report takes the type (accident, near miss, dangerous occurrence, property damage or other), the date, time, site and exactly where it happened, what happened, what was done straight away, who was hurt, the injury and treatment, witnesses and the root cause. Each report has a severity and a status from reported through to closed, and can be entered on a phone. Jobs that come out of it can be set up as actions with a person and a due date. It does not submit RIDDOR reports: that is done on HSE's website.

Questions people ask