Free Retail Accident Report Form Template
Retail Accident Report Form
Please fill out this form completely to document any accidents or incidents occurring in the retail environment.
Date and Time of Accident
Location
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Office Area
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Conference Room
-
Parking Lot]
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Name of Injured Party
Department/Team
Role
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Customer
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Employee
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Visitor
Type of Incident
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Slip
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Fall
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Collision
Describe the Accident
Witness Name 1
Phone number
Witness Name 2
Phone number
Upload Relevant Files
Were there any injuries?
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Yes
-
No
If yes, please input the details of the injury sustained.
Body Part(s) Affected (if applicable)
First Aid Given?
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Yes
-
No
Medical Attention Needed?
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Yes
-
No
Other Impact on Work or Workplace
Immediate Actions Taken
Staff Responsible for Handling Incident
Manager/Supervisor Name
Phone Number
Additional Notes or Recommendations
Employee |
[Your Name] Manager/Supervisor |
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