Accident Report Form

Accident Record

This Accident Record Form should be available to all employees so that an injured employee, or someone acting on their behalf, can complete the form as soon as possible after the accident. The Accident Record Form should then be passed to the Duty Holder for secure safekeeping and monitoring.

The record provides for:
1. Record Number
2. Details of injured party
3. Details of reporting party
4. Accident details
5. Signature of reporting party
6. Employer only section in respect of RIDDOR, and Internal Accident Investigation Report.

This template is in fixed field format and contains macros. All macros are virus free. Always click "enable" if an automatic pop-up appears.

Simply press TAB to jump from one field to the next and SHIFT + TAB to go back. Alternatively, use the mouse to click from one field to the next.

The template can be unlocked by clicking on the "Padlock" icon on the tool bar.

For further information on Macros and "Padlock" please refer to the Help section.