Company / HR
Employee Accident Report Template
This template helps managers and HR document any accident involving an employee, with a dedicated section for corrective actions and root cause, useful for internal compliance tracking.
What this template includes
Every field below is part of the free template and the mobile version — nothing is locked behind a paywall for filling out a single report.
- Report number and date/time of the incident
- Location or site
- Reporter's name and role
- Severity (minor, moderate, or critical)
- Person(s) involved — name, role, contact
- Witness(es) — name, phone
- Description of events
- Immediate action taken and root cause (if known)
- Up to 3 timestamped photographs
- Reporter signature
- Witness or supervisor signature
Common use cases
- On-duty accident
- Medical incident or illness at the office
- Accident involving office equipment
- Incident during a business trip
Frequently asked questions
How should I structure corrective actions?
The form has dedicated "Immediate action" and "Root cause" fields, so you document not just the incident but also the steps taken to prevent it from happening again.
For the federal recordkeeping rules referenced above, see OSHA's recordkeeping requirements.
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