Incident Report Form
Capture an incident properly on the day, in the affected person's own words, with the witness details and equipment notes that become impossible to gather later.
IN-03 2 pages
Incident and first aid records · IN-04
Accident Book Page
A free printable single-page accident record — the person, the accident in their own words, the injury, what was done and who recorded it.
Download Free · no sign-up
One page. Choose your paper size — both versions are laid out identically, so neither one gets shrunk to fit.
Print it and write on it
Fill it in type and save
The fillable versions have real form fields — open them in any PDF reader, type into them and save. Printing help.
What this sheet is for
Record one accident on one page, so the completed record can be filed securely rather than left in a book for the next person to read.
Who it is for
Small employers, clubs, halls, shops, schools, care settings and any premises where an accident might happen to a visitor.
How to use it
- Complete it the same day, in the injured person's own words where possible.
- Read it back to them before anyone signs.
- File the completed page securely, separately from the blank ones.
- Complete any formal report your local rules require as well.
- Review the pages together periodically — patterns show across them.
What is on the sheet
The layout is fixed at a size that fits both A4 and US Letter, so the A4 and Letter files are visually identical and print at full size on either. Rows are set at a height that an adult can actually write a date and a few words into with a pen — most printable tables are built in a word processor and never tested with one.
Questions
Why single pages rather than a bound book?
Because a bound book shows everybody's personal details to whoever fills in the next line, and in many countries that information has to be kept confidential. Separate pages can be filed away as soon as they are complete.
Does completing this discharge a reporting duty?
No. What must be reported, to whom and within what time differ by country and by the kind of premises or work. This page names no scheme — check what applies to you and keep this alongside whatever that requires.
Related sheets
First Aid Treatment Log
Keep a running record of first aid given so that supplies used and patterns of injury are both visible in one place.
IN-05 1 page
Near Miss Report Form
Capture the things that nearly went wrong, in a form that asks what happened rather than who was at fault.
SI-10 1 page
One new sheet, most weeks
We are building this library out steadily. Leave an address and we will send the new sheets as they are finished — nothing else, and no more than one email a week.
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