How to complete an incident report: Incident report example

When you have an incident on-site, whether it’s a near miss, an injury, or a work-related illness, you will need to write an incident report.

Incident reports don’t need to be time-consuming,  lengthy or use fancy health and safety terms, you just need to describe what happened in your own words so you have a record of the incident. You can use the incident report to help explain what happened to others, such as your direct team on-site, contractors,  other Employers, or the Principal Contractor.  

What is an incident report?

An incident report is the process of recording incidents on-site, such as near misses, injuries, illnesses and plant/property damage. It involves documenting all the facts (known so far) related to the incident. 

Check out this blog on Managing and reporting incidents at work to learn more about what is considered an incident and why it’s important to report incidents. 

How to complete an incident report: Hit body on object example incident report

Hitting your body on an object is a very common example of an incident. For this incident report example, we will assume someone on site has hit their body on a door frame and injured their shoulder.

Site Location

32 Dropsaw Lane, Wellington 6011

Date of Incident
2nd September 2023

People involved

Joe Hazard (injured)

Sam Small (witness)

Larry Large (witness)

Type of Incident

Near Miss (Something bad almost happened)

✅ Injury (Someone was hurt)

Illness (Word related illness)

Other (Something else happened)

Incident (Damage caused, electric shock, substance leak)

Treatment received

First aid (performed on site)

✅ Medical Centre (Medical treatment required)

Hospital (Admitted for injury or illness)

Unsure (I’m not sure what treatment was given)

None (No treatment required)

Describe what happened –  List the facts that are known so far about the incident such as :

*what job or activity was being performed at the time.

*What plant, equipment or tools were being used

*What went wrong

*What was the injury or damage (or the potential)

*What happened immediately after the incident

Joe Hazard was carrying plywood through a doorway on-site when he hit his shoulder on the door frame. Joe felt immediate pain in his left shoulder and struggled to lift his arm above shoulder height. Joe informed Sam Small (Supervisor) immediately and agreed to go to the local medical centre for further assessment

This is an example of a simple incident report, find out more about what good incident reporting looks like. 

If you’re a HazardCo member, hit the Report an Incident button in the HazardCo App and follow the guided prompts to record the incident. Your membership includes 24/7 incident support, so if you need some extra help filling in the report, would like advice on if the incident is notifiable to the Regulator, or would just like to chat with an expert about how to communicate the incident to your team, we are here to help! 

Remember

When you have an incident on-site, writing an incident report is just one action you need to take. Learn more about what to do when you have an incident on site.