HTML Preview Health Safety Incident Investigation Report page number 1.


Use this template to record your investigation findings and outline your recommendations. The extent of
detail will be dependent on the severity of the incident. On completion save this template electronically and
upload it as a File Attachment to the MyHR Workplace Health and Safety on-line reporting system.
Summary of Investigation Findings
HEALTH AND SAFETY
INCIDENT INVESTIGATION REPORT
INC-
Investigation Team Leader
Role (e.g. Deputy Principal, Project Officer, Teacher, etc)
Signature / Digital signature
The summary should outline the event, who was involved, what happened, the scope of the investigation,
the analysis and outcomes and any recommendations to prevent or minimise the recurrence of the incident
MyHR WH&S INCIDENT ID
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