Incident Form | Islandinncondo

Island Inn Condominium Association

Incident Report Form

Important Information:

An incident can be defined as:

any injury to a person, or
damage to property, or
a “near-miss” where there was potential for injury or damage.

What is an Incident Report Form used for?
An investigation should concentrate on identifying what actions or events led to the incident, and to identify strategies to ensure that the incident is addressed and controlled. Outcomes of investigations will strengthen the safety systems and methods of work within a company.

Incident Reporter First Name

Incident Reporter Last Name

Incident Reporter Phone

Date and Time of Incident

The Incident

What was the Incident / Near Miss?

Were there any injuries?

Involved/Injured - First Name

Last Name

Phone

Staying in Unit number?

Photo ID / Driv License

Injury Photo 1

Injury Photo 2

Injured Person's Signature

Was there any damage to property?

What caused the incident?

What could have prevented the incident

Thanks for submitting!