Form · MHSWR regulation 3
RAMS template
Risk assessment and method statement for one activity: the sequence of work, a five by five risk matrix, PPE, permits, rescue, and a briefing record signed against the revision.
Free download · Editable PDF
Free incident report form
An incident report form records an accident, a near miss or a dangerous occurrence while the facts are fresh: who, where, what happened, and whether HSE must be told. This one adds the RIDDOR check and an investigation page, as an editable PDF and a Word document, free to use and reuse.
- Format
- Editable PDF
- Pages
- 3
- Built on
- RIDDOR 2013 and HSE guidance HSG245
- Cost
- Free, always
What is in the incident report form
3 pagesWhat happened
The kind of event, the site, date, time and exact place, the person involved with their occupation and injury, first aid, hospital, a description in order, and the witnesses.
The RIDDOR check
The specified injuries listed to tick, the seven-day and three-day rules, members of the public taken to hospital, dangerous occurrences, and when and how the report went to HSE.
Made safe and who was told
What was done straight away, and the employer, principal contractor, insurer and next of kin told.
The investigation
The immediate, underlying and root causes, how much worse it could have been, the actions with owners and dates, the briefing, and sign-off.
What RIDDOR asks of an incident record
Checked against the sourceReporting
Deaths, specified injuries, dangerous occurrences and members of the public taken to hospital are reported without delay, and the report must arrive within 10 days. An injury that keeps a worker off normal duties for more than seven consecutive days is reported within 15 days.
RIDDOR 2013, regulations 4 to 7; HSE, When do I need to report an incident?The record
The responsible person keeps a record of every reportable incident, and of every injury that keeps a worker off for more than three days. It holds the date and time, the person’s name, occupation and injury, the place, the circumstances, and when and how it was reported. It is kept for at least three years.
RIDDOR 2013, regulation 12 and Schedule 1 Part 2The accident book
An employer with ten or more people normally employed at the same premises keeps an accident book, and keeps each entry for three years.
Social Security (Claims and Payments) Regulations 1979, regulation 25How to use it
Report near misses the same way
A near miss is the same event without the injury. HSE’s HSG245 treats it as the cheapest lesson a site gets.
Write facts, not blame
The description is what happened, in order. The causes go on the investigation page, where they can be looked at as a system.
Watch the clock
In Unibuild the accident report records whether the event is reportable and why, the reporting window is flagged, and alerts go by email and push notification. See health and safety in Unibuild.
Asked most often
Questions about
Questions about
this template.
Is this incident report form free?
Yes. It is free to download, use and reuse, including on paid work and for clients, with no sign-up and no email address. Download the editable PDF or the Word version.
What should an incident report include?
The date, time and place, the person involved with their occupation and injury, what happened in order, the witnesses and the first aid given. Then whether it is reportable under RIDDOR, what was done straight away, and the investigation with its actions.
What is the difference between an accident and a near miss?
An accident causes injury or ill health. A near miss is an event that caused no injury but could have. Both are reported and investigated, because the causes are usually the same.
When does an accident have to be reported under RIDDOR?
Deaths, specified injuries such as most fractures and amputations, dangerous occurrences and members of the public taken to hospital are reported without delay. An injury keeping a worker off normal duties for more than seven consecutive days is reported within 15 days.
How long must accident records be kept?
At least three years. RIDDOR records are kept for three years from the date they were made, and accident book entries for three years from the date of entry.
Who reports to HSE?
The responsible person: usually the employer of the injured worker, or the person in control of the premises for the self-employed and members of the public. Reports are made online, or by phone for deaths and specified injuries.
How does Unibuild handle incident reports?
Accidents and near misses are recorded on the phone against the job with photographs. The report records whether the event is reportable and why, and the reporting window is flagged with email and push alerts. Incident figures come from the record for pre-qualification. See health and safety.
More free downloads
All 134 downloads →
Form · CDM 2015 regulation 15
Method statement template
How one activity on one site will be carried out. Two pages of sequence with the controls at each stage, then plant, PPE, permits, rescue and a briefing record.
Assessment · COSHH 2002 regulation 6
COSHH assessment
One hazardous substance: its hazards from the data sheet, who is exposed and how, controls in regulation 7 order, PPE and RPE, storage, spills, first aid, monitoring and review.
Next step
The same records,
The same records,
without the paper.
On the platform these stop being sheets. The check, the person, the date, the signature and the action that followed are recorded as the work runs and retrieved by site.