Warehouse Incident Report Form
Warehouse Incident Report Form
Please complete this form to document any incidents that occur in the warehouse.
Incident Details
Date of Incident
Time of Incident
Location of Incident
Specific warehouse area or section
Type of Incident
-
Injury
-
Equipment Damage
-
Property Damage
-
Near Miss
-
Hazardous Material Spill
-
Option 6
Incident Description
Provide a detailed account of what happened, including the sequence of events leading up to the incident.
Was there an injury?
Injured Party Details
Skip if no injury occurred
Name of Injured Person
Position/Job Title
Phone Number
Injury Description
Specify body part affected, nature of injury
Was First Aid Administered?
If yes, by whom?
Was medical attention required beyond First Aid?
If yes, where was the person taken?
Equipment or Property Damage
Was any equipment or property damaged?
Describe the damaged equipment or property
Damage Severity
-
Minor
-
Moderate
-
Major
Action Taken to Secure Damaged Area/Equipment:
Corrective Actions
Immediate Action Taken to Address the Incident
Recommendations to Prevent Future Incidents
Upload anything related with the incident
Reporting Information
Reported By
Name and Position
Date Report Completed
Manager/Supervisor Review
Name:
Date:
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