Accident Incident Report Checklist

This checklist is used to report incidents, accidents and injuries at the construction site. It records the vital details of the incident like date, time, evidence and causes so that a thorough investigation can be performed. It ensures that near-miss situations are also reported for a future plan and analysis.

Description of worker injury
Was first aid provided?
Was medical aid provided?
Was there any time lost?
Any modified work
Was the injury fatal?
Name of worker
Age
Occupation
Nature of injury
Details of vehicle/property damage
Add image
Estimate cost/loss
Details of damage
General
Date
Type of accident
Person involved
Concerned department
Site supervisor on duty
Was there an injury?
Was the injury severe?
Was first aid provided?
Was there damage to the property?
Did the damage have a major potential?
Were there any spills?
Any near miss reported?
Was there a fire incident?
Were any vehicles involved?
Any other issue reported?
Explain more
Add image
Name of witness
Signatures
Worker
Supervisor

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