Injury Reporting Form


It’s important that employers know when a worker has been injured for several reasons. First, if you don’t know when such an injury occurs, you can’t take steps to prevent similar injuries. Second, you may need to report certain injuries, especially serious ones, to your jurisdiction’s OHS regulator and/or the workers’ comp board. So make sure that workers know that they’re required to report injuries to a supervisor, OHS coordinator or other designated individual.


To make it easy for workers to report injuries and gather the information you’ll need about such injuries, adapt this form for your operations, OHS program and the requirements in your jurisdiction’s OHS laws on injury reporting and make it available to all employees. Train employees on how and when to complete the form and to whom they should submit it.