Templates
HR
Workplace Injury Report Form Template

Workplace Injury Report Form Template

The Workplace Injury Report Form serves as an official record of incidents involving workplace injuries or illnesses. It helps document what happened, who was involved, when and where it occurred and what medical care was provided.

Originally published by luminpdf.com

Used 70 times

Copy link
Report

Effortlessly edit PDFs anywhere

Save time and tackle any paperwork task with ease
Handle confidential information and signatures securely
Send work, negotiate terms and sign everything off with Lumin Sign

Workplace Injury Report Form with sections for employee details, incident description, witnesses, medical treatment and supervisor recommendations

1/4

Used 70 times

Frequently asked questions

This Workplace Injury Report Form records all relevant information about a work-related injury or illness. It includes sections for employee details, incident description, medical treatment, witness statements and supervisor recommendations. The form helps ensure accurate reporting, supports compliance with safety regulations and promotes preventive actions in the workplace.
It is filled out by the injured employee, their supervisor or the workplace safety officer responsible for incident documentation.
Once completed, the form should be submitted to the HR department or occupational health and safety officer for recordkeeping and if required, forwarded to local labor or regulatory authorities.

Discover Lumin’s products

Collaborate with existing colleagues and onboard new ones with Lumin and Lumin Sign. Our innovative solutions work great on their own, but they’re even better together.