This form is designed to assist you in promptly and accurately documenting any workplace incidents. By providing detailed information, including witness accounts and supervisor remarks, you play a crucial role in maintaining transparency and ensuring that issues are addressed effectively. Your commitment to reporting contributes to a safe and compliant work environment for everyone.
Employee Name: | |
Employee ID: | |
Department: | |
Position: | |
Date Reported: |
Date of Incident: | |
Time of Incident: | |
Location of Incident: |
Describe the incident.
Witness Name: | |
Contact Information: |
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