Construction Accident Incident Report
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How to create a Construction Accident Incident Report? Download this Construction Accident Incident Report Form template now!
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How to draft a Construction Accident Incident Report? What are examples of construction incident reports? An easy way to start completing your document is to download this Construction Accident Incident Report now!
This construction accident incident report form template is created after an incident happens, which means when something that happens, possibly as a result of something else, has to be reported, because it did damage. A commonly used incident, is for example of an incident is noticing an airplane in the sky, while taking a walk (a particular occurrence, especially one of minor importance to the person). However, the incident (accident) that this report type is referring to, has more to do with a violation of the law, for example the incident where someone is going to jail after being arrested for shoplifting. Something incident to something else. This sample Accident Incident Report template can help you find inspiration and motivation. This Sample Accident Incident Report covers the most important topics that you are looking for and will help you to structure and communicate in a professional manner with those involved.
Accident/Incident information
- Was a drug and alcohol test performed (if applicable) and results submitted to the
- COATS database administrator Contractor Accident / Incident Report
- CONTRACTOR ACCIDENT / INCIDENT REPORT
- Please Select Type: Employee Injury Subcontractor Injury Accident Incident Property Damage/Stolen Property
- INJURED PARTY/CLAIMANT: Occupation When Injured:
- TIME AND PLACE OF ACCIDENT / INCIDENT
- Did Accident Occur on University Premises Yes No Accident Location (Job Name): Job No.: Address: Date: State/Zip: Time: Lost Time: Yes No Name of Foreman/Supervisor: Last Day Worked: Return to Work: Reported to Employer: To Whom was Accident Reported: Were University Personnel On Site When the Accident/Incident Occurred Yes No
- DESCRIPTION OF ACCIDENT / INCIDENT (completed by employee) See Attached Employee Description
- WITNESS CONTACT INFORMATION See Attached Witness Contact Info MEDICAL ATTENTION: Was Medical Attention Provided: Yes Name of Doctor/Hospital: No When: Phone No.: Address of Doctor/Hospital: Did this accident/incident meet the criteria for a post-accident/incident drug and alcohol test as defined by the COATS Substance Abuse Program Yes No Yes If yes, were applicable drug and alcohol tests performed and submitted to the COATS database administrator No If no, explain why
- SIGNING THIS REPORT DOES NOT CONSTITUTE
- CERTIFICATION OF AN INDUSTRIAL CLAIM (signatures) Employee Signature Date Employee (typed or printed) University Project Administrator Signature Date University Project Administrator (typed or printed) Phone NOTE:
- THIS REPORT MUST BE TRANSMITTED TO THE UNIVERSITY WITHIN 24 HOURS OF THE ACCIDENT/INCIDENT
Feel free to download this intuitive construction accident report form template that is available in several kinds of formats, or try any other of our basic or advanced templates, forms or documents. Don't reinvent the wheel if an accident/incident happens for the first time, that is worth recording. Make sure the information is logged well in the report, so it can be a point of reference in the future if needed.
Download this Construction Accident Incident Report Form template now and save yourself time and effort! You will see completing and submitting your incident form just became a little easier.
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