Free Restaurants Accident Report Form Template
Restaurant Accident Report Form
Please complete this form to report any accidents or incidents occurring within the restaurant premises.
Date and Time of Accident
Location
Specific Location within the Restaurant
Reporter Name
Job Title
Company Name
Phone number
Name of Injured Employee
Incident Description
Provide a detailed account of the incident. Include events leading up to, during, and following the occurrence.
Witness Name 1
Phone number
Witness Name 2
Phone number
Upload Relevant Files
Were there any injuries?
-
Yes
-
No
Description of Injuries or Damages
Describe the type and severity of injuries. Specify who was injured and their condition.
Immediate Actions Taken
Describe actions taken to address the incident, such as first aid, cleanup, or equipment repairs.
Was the incident reported to a supervisor?
-
Yes
-
No
Supervisor Name
Phone Number
Additional Comments
Include any further information, suggestions, or recommendations to prevent future occurrences.
|
Reporter |
[Your Name] Manager |
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