Incident Report Template

Incident Report Template

This template provides a structured, tiered approach to incident documentation. Not every incident requires the same depth of reporting — the template helps you apply the right level of response.

How the Template Works

The system uses a two-tier approach:

Tier 1 — Basic report (for minor incidents and near misses):

• What happened, when, where
• Who was involved
• Immediate actions taken
• Any injuries or damage
• Whether a follow-up investigation is needed

Tier 2 — Full investigation report (for serious incidents or notifiable events):

• All Tier 1 information
• Root cause analysis
• Contributing factors
• Witness statements
• Corrective actions and owner
• Review sign-off

When to Use Each Tier

Use Tier 1 for:

• Near misses and minor incidents
• Minor first aid events
• Equipment failures with no injury

Use Tier 2 for:

• Any injury requiring medical attention beyond basic first aid
• Notifiable events (must also be reported to WorkSafe)
• Incidents with significant property damage
• Any incident that could have caused serious harm

Who Completes the Report

The staff member present at the incident should complete the initial report as soon as practicable after ensuring everyone is safe. A manager should review and sign off within 24 hours for Tier 1, and conduct or commission a full investigation for Tier 2.

Keeping Records

All incident reports should be stored securely. Notifiable event records must be kept for at least five years. Do not destroy incident records — they may be required by WorkSafe or in legal proceedings.