incident documentation checklist

Date: _______________________


1. Location and Time
- Note the exact location where the incident occurred.
- Record the date and time of the incident.


2. Description of the Incident
- Provide a detailed account of what happened, including:
- Events leading up to the incident
- Actions or behaviors of individuals involved
- Sequence of events during the incident
- Any equipment or objects involved
- Weather conditions, if relevant


3. Witnesses
- Identify any witnesses present during the incident.
- Obtain their contact information (name, phone number, email).


4. Injuries and Damages
- Document any injuries or damages resulting from the incident.
- Take photos or videos of the injuries or damaged property, if possible.


5. Reporting
- Report the incident to your supervisor or manager as soon as possible.
- Follow the established reporting procedures of your company.


6. Medical Treatment
- Seek appropriate medical attention for any injuries sustained.
- Keep copies of medical records, prescriptions, and treatment plans.


7. Additional Documentation
- Preserve any relevant documents related to the incident, such as:
- Incident reports filed by your employer
- Safety equipment maintenance records
- Training or safety procedure manuals


8. Personal Statement
- Write a personal statement detailing your perspective of the incident.
- Include your observations, actions taken, and any concerns.


9. Contact Information
- Keep a record of contact information for relevant parties, such as:
- Employer's representative handling the incident
- Human resources department
- Union representative, if applicable
- Legal counsel, if necessary


10. Follow-Up Actions
- Keep track of any follow-up actions taken, such as:
- Conversations or meetings with supervisors or investigators
- Correspondence with medical professionals or insurance providers
- Any changes in your work duties or conditions following the incident


Remember, it's essential to document the incident accurately and promptly. Consult with your employer or legal counsel for specific guidelines or additional steps to follow based on your workplace and the nature of the incident.


Disclaimer: This checklist is provided for informational purposes only and does not constitute legal advice. Always consult with a qualified professional to address your specific situation and ensure compliance with applicable laws and regulations.