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Incident report form

For workplaces, venues, schools and volunteer groups that need an internal record of what happened, made while it's fresh. Reports from a phone go straight to one sheet, which becomes your incident log. Near misses are included, because they're the incidents that warn you.

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Copies the form into your account after you sign in with Google. You can change anything before publishing.

Incident report form· preview, nothing is sent

Columns in your Google Sheet

Each response becomes one row with these columns.

_submission_id_submitted_at_form_versionYour nameYour phoneWhat kind of incident?Date it happenedApproximate time it happenedExact locationWhat happened?Was anyone hurt?People involved and witnesses (names and contact details)What was done straight away?

What this form asks, and why

  • Your namerequired Who to ask for more detail.
  • Your phonerequired Follow-up questions are best asked while memories are fresh.
  • What kind of incident?required Count near misses next to injuries to see patterns before someone is hurt.
  • Date it happenedrequired When it happened, which can differ from when the report was sent.
  • Approximate time it happenedrequired Typed text, because the form has no time field yet.
  • Exact locationrequired 'Loading dock, bay 3' is something you can fix; 'warehouse' isn't.
  • What happened?required A minimum length, and a prompt to give facts in order rather than blame.
  • Was anyone hurt?required Shows at a glance which reports may need to go to a regulator.
  • People involved and witnesses (names and contact details) Witness statements get harder to collect every day.
  • What was done straight away? Shows what was made safe and what is still open.

Fields people often add

  • Equipment or vehicle involved
  • Supervisor on duty
  • Suggested way to prevent it

Common mistakes

  • Treating this form as the official notification: serious incidents must also be reported to the regulator, often within hours. In the US, OSHA requires a fatality to be reported within 8 hours and an in-patient hospitalisation, amputation or loss of an eye within 24, by phone or online (email doesn't count).
  • Reading _submitted_at as the incident time: it's when the form was sent, in UTC. The date and time questions record when the incident happened.
  • Putting medical detail in a widely shared sheet: describe the injury, not the person's health history, and limit who can open the sheet.
  • Only reporting injuries: near misses show the same hazards without anyone getting hurt, so make them easy to report.

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Publish to get a link on freelyforms.link, or embed it on your website. Responses go to your Google Sheet.

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