Free Construction Site Accident Report Form Template
Construction Site Accident Report Form
Please fill out this form completely to report any accidents or incidents that occur on the construction site.
Personal Information
Name
Job Title
Phone number
Accident Information
Date and Time of Accident
Location of Accident
Type of Accident
Please provide a brief description of the accident
Injury Details
Injured Person
Type of Injury
-
Cuts
-
Fractures
-
Bruises
-
Severity of Injury
-
Major
-
Minor
Was medical attention required?
If yes, please specify
Witness Information
Witness Name
Phone number
Witness Statement
Reported to Supervisor
Name of Supervisor Notified
Date and Time Reported
Signature
By signing this form, I confirm that the information provided is accurate to the best of my knowledge.
Name:
Date:
Accident Report Form Templates @ Template.net
Thank you for submission!
We appreciate you taking the time to submit.
Create free forms at Template.net
