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Incident Investigation Form


When a safety incident occurs in your workplace’whether someone is injured or killed or it’s a near miss’you must investigate it. Documenting your investigation is important because you may need to prove down the road that you exercised due diligence to prevent similar incidents from happening.


Use this Model Incident Investigation Form to record what happened, the workers involved, the likely causes of the incident and proposed steps for addressing identified hazards or issues and preventing similar incidents, both in the short- and long-term. Tailor this form to reflect the incident investigation protocol in your workplace.