Free Laboratories Incident Report Form Template
Laboratories Incident Report Form
Please fill out this form completely to document any incident occurring in the laboratory.
Date
Incident Location
Reporter's Name
Reporter's Email
Please provide your email address.
Reporter's Phone Number
Role in the Laboratory
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Lab Technician
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Researcher
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Student
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Visitor
Type of Incident
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Chemical Spill
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Equipment Failure
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Biological Hazard
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Injury
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Detailed Description
Provide a clear account of what occurred, including the sequence of events, materials involved, and potential causes.
Immediate Actions Taken
Describe steps taken to contain the situation, assist injured persons, or secure the area.
Was there exposure to hazardous substances?
Were there any injuries?
Relevant Files or Documents
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Supervisor |
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