Workplace incident report
A workplace incident report capturing the facts of an injury, near-miss, or safety event. Designed to feed provincial workers'-comp / WSIB / WCB filings and OSHA recordkeeping.
Workplace Incident Report
1. When & where
Date: · Time: · Location:
Type of incident:
2. Who
Person involved:
Witnesses:
3. What happened
4. Injuries / damage
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5. Immediate actions
6. Initial root-cause assessment
7. Corrective actions
8. Regulator reporting
OSHA requires recordable injuries to be entered on the OSHA 300 log within 7 calendar days. Fatalities must be reported within 8 hours; in-patient hospitalizations, amputations, and eye losses within 24 hours. State-specific workers'-compensation reporting timelines also apply.
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Made with WalnutsHR Paper · Reviewed for United States (general) · April 2026
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No compliance hints for this jurisdiction yet — your document looks good for the basics. Have a lawyer review before sending anything consequential.
About this template
An incident report serves three purposes at once: regulatory record (provincial workers' comp, OSHA 300), organizational learning (root cause + corrective action), and legal documentation (objective, contemporaneous account). The discipline of writing one for every incident — including near-misses — is what keeps a safety program honest.
When to use it
- Any work-related injury, regardless of severity.
- Property damage, fire, environmental release, or near-miss.
- Workplace harassment or violence incident (combine with the harassment policy's investigation procedure).
What to include
- When, where, and what type of incident.
- Who was involved and who witnessed.
- Factual description — sequence of events without speculation.
- Injuries or damage observed at the time.
- Immediate actions taken (first aid, isolation, notification).
- Initial root-cause assessment, even if marked "under investigation".
- Corrective actions with owners and dates.
- Reference to applicable regulator timelines.
Frequently asked questions
Should we report near-misses?
Yes — they're the most valuable category of incident report. Near-misses surface latent hazards before someone is hurt. Most regulators don't require near-miss reporting, but mature safety cultures track them as a leading indicator.
What goes in the regulator filing vs the internal report?
Regulator forms (Form 7 in Ontario, equivalent in other provinces, OSHA 300 in the US) capture a regulator-specific subset. The internal incident report is more detailed and more candid about root cause; a clean separation between the two protects both internal investigation candor and regulatory compliance.
Legal disclaimer. Incident reports are subject to discovery in litigation and may be reviewed by regulators. Stick to facts; avoid speculation, blame, and conclusory statements ("the employee was careless"). Critical-injury / fatality reporting timelines are short — confirm the obligations for your jurisdiction before completing the report.
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