When a team member is hurt, a customer slips or stock goes missing, the record written that day is the one people rely on later. This employee incident report template takes you through the facts in order: when and where it happened, who was there, what happened, what was done straight away and what happens next. It prints with signature lines for the reporter and the manager who reviews it. The editable sample is a fictional shop's report of a customer who slipped on November 3, 2026.
Make an incident report
- Give the report a title and, if you use them, a reference number and the business name. Enter the location, the incident date and time, where exactly it happened, such as "Aisle 4, in front of the chilled drinks fridge", and the type: injury, near miss, property damage, customer complaint, theft or security, or other.
- Add each person involved and each witness, with their role, how they were involved and a contact if you need one. Note what each person said or saw. An injury report needs at least one person marked Injured.
- Describe what happened, then the immediate action taken. Choose the first aid or medical attention given and whether the incident was reported to an authority.
- Add follow-up actions, each with an owner and a due date, then your name, role and the report date. A manager can complete the review now or on paper.
- Read the wording check, then print or download the report. A report holds up to 12 people and 10 actions.
Start blank opens a fresh report dated today with one person marked Injured, keeping your own business and location. Reset sample brings the example back.
How to write an incident report
Write it as soon as you can, while people remember the details, and keep to what was seen, heard and done. Put events in the order they happened, with times where you know them. Name who saw each thing. "Dana said her left wrist hurt" is a fact. "She was not looking where she was going" is an opinion, and it does not belong in the report.
Leave the causes to the review. A report that says who was at fault or what someone should have done can stop people speaking openly next time, and it may be wrong. The wording check looks for a short list of blame words, guesses, hindsight and opinions stated as facts, and quotes each one it finds. It is a hint and never blocks printing. In this incident report example, it quotes "probably" from Jordan Lee's account: "The floor was probably wet from the fridge." Jordan saw the fall, not where the water came from, so his account should keep to what he saw. The description already records the water dripping from the fridge door.
Each person's account works as a short witness statement. For a serious incident, ask each witness to write and sign their own statement, and keep it with the report.
What should an incident report include?
A complete record answers six questions: when and where it happened, what kind of incident it was, who was involved or saw it, what happened in order, what was done straight away, including first aid, and what will change. The follow-up actions turn the last answer into named tasks with dates. A repair can become a maintenance work order, and a new routine check can go on the opening checklist.
The same layout works as a near miss report. A box that falls from a high shelf into an empty aisle hurts nobody, but it shows where the next injury could happen, so record it the same way. Some teams call this an accident report form, and others keep one workplace incident report form for every type. Use whichever name your team knows.
If a shift ends with an incident still open, note it on the shift handover so the next lead knows to follow up, and keep the formal record here.
Reporting incidents to authorities
Rules on recording and reporting incidents vary by place and industry, and this tool is not legal advice. In Great Britain, RIDDOR sets out which injuries, diseases and dangerous occurrences must be reported to the Health and Safety Executive. In the US, employers must report to OSHA a work-related fatality within 8 hours, and an in-patient hospitalization, amputation or loss of an eye within 24 hours. Check the rules where you work.
Choose Yes for "Reported to authorities" to record who it was reported to, their reference and the date. Not decided yet leaves the question for the manager review. Marking a report does not file it with anyone.
Print, sign and keep the report
Print / PDF prints the preview: the details, the people, the account, the response and the follow-up table. With no actions, the table prints empty rows to write in. An empty manager review prints lines for the reviewer's name, date, notes and signature, so a manager can complete it by hand.
The text download keeps a readable copy. The CSV download is one row with the date, type, people, actions and review, ready to paste into an incident log spreadsheet. A report can hold health details, so keep copies where only the people who need them can see them.
Frequently asked questions
Can I write an incident report without an account?
Yes. The builder runs in your browser and needs no sign-up. The draft stays in this tab when you refresh. Download or print the report to keep it.
Can I use it for a near miss or a customer complaint?
Yes. Choose the type that fits, or Other and describe it. Only an injury needs a person marked Injured.
Who should fill in the report?
The person who saw the incident or dealt with it, as soon after it as possible. A manager then reads it, completes the review and decides on the actions.
Does the report send anything to an authority?
No. Nothing is uploaded or sent. Recording that you reported an incident does not report it; make the report through the authority's own process.