Unlock hundreds more features
Save your Form to the Dashboard
View and Export Results
Use AI to Create Forms and Analyse Results

Forgot Password?
Get Started
OR
Sign UpLogin With Facebook
Sign UpLogin With Google

Construction Accident Report Form Template

Streamline Reporting with Our Construction Accident Template

In the chaotic aftermath of a construction accident, timely documentation is crucial. This Construction Accident Report Form Template is designed for construction managers and safety officers seeking a straightforward way to document incidents and ensure compliance. With this template, you can quickly capture vital information, facilitate a thorough investigation, promote workplace safety, and improve communication with stakeholders-all while adhering to industry standards. Explore the live template to see how simple it can be.

Use this Template (FREE) Live Preview
Your full name
Company or employer
Email
Phone number
Your role in relation to this incident
Injured person
Supervisor
Witness
Safety officer
Site manager
Other
Please Specify:
Date of incident
Time of incident (HH:MM and AM/PM, if known)
Location or site name
Specific area or address
Project or job number (if applicable)
Incident type (select all that apply)
Injury
Illness
Near miss
Property damage
Environmental incident
Vehicle incident
Fire or explosion
Tool or equipment failure
Other
Please Specify:
Did anyone suffer an injury or illness?
Yes
No
Injured or ill person's full name
Employment status
Employee
Contractor
Subcontractor
Visitor
Member of the public
Unknown
Job title or trade
Direct supervisor name
Initial injury severity assessment
First aid only
Medical treatment
Restricted work
Lost time
Fatality
Unknown
Body part(s) affected
Nature of injury or illness
Please Specify:
Task being performed at the time
Describe what happened
Contributing factors (select all that apply)
Please Specify:
Weather and conditions at the time
Please Specify:
Lighting conditions
Good
Adequate
Poor
Dark
Glare
Unknown
Surface conditions
Dry
Wet
Icy or snowy
Oily or greasy
Uneven
Obstructed
Unknown
Was any equipment, tool, or material involved?
Yes
No
Specify the equipment, tool, or material (make, model, ID if known)
Was PPE required for this task?
Yes
No
PPE worn at the time (select all that apply)
Please Specify:
Was first aid provided on site?
Yes
No
Who provided first aid (name or role)
Was external medical care needed?
Yes
No
Was the person transported to a clinic or hospital?
Yes
No
Were emergency services called?
Yes
No
Was work stopped for this task or area?
Yes
No
Immediate corrective actions taken
Who was notified
Please Specify:
Estimated days away from work or restricted work (if known)
Is this case OSHA recordable (if applicable)?
Yes
No
Witness full name
Witness phone number
Witness statement
Were there any witnesses?
Yes
No
Primary root cause category
Human factors
Equipment or material
Environment
Process or procedure
Training or competency
Supervision or management
Design or engineering
Unknown
Recommended corrective or preventive actions
Likelihood of recurrence without changes
Very unlikely
Unlikely
Neutral
Likely
Very likely
Target date to complete corrective actions
Responsible person for follow-up
Potential severity if repeated
Minor
Moderate
Serious
Severe
Catastrophic
Unknown
Name of person submitting
Date of submission
Signature
I confirm the information provided is accurate to the best of my knowledge
Strongly disagree
Disagree
Neither
Agree
Strongly agree
{"name":"Your full name", "url":"https://www.quiz-maker.com/QPREVIEW","txt":"Your full name, Company or employer, Email","img":"https://www.quiz-maker.com/3012/images/ogquiz.png"}
Paper art illustration depicting a construction accident report form for FormCreatorAI article.

When to use this form

Use this form as soon as a worker, subcontractor, or visitor is hurt or property is damaged on your jobsite. It fits falls from scaffolds, struck-by incidents, equipment failures, or chemical splashes. You can capture facts while memories are fresh, assign follow-up, and support insurance and compliance. If the event involves an employee injury, also complete the Employee incident report form. For close calls that did not cause harm, log them using the Near-miss incident report form. If law enforcement responds or a citation is issued, attach the Police incident report form.

Must Ask Construction Accident Report Questions

  1. What were the exact date, time, and location of the incident?

    This pins down when and where it happened so you can match shift rosters, permits, and weather records. Accurate details speed root cause analysis and help verify surveillance footage.

  2. What task was underway, and which equipment, materials, or PPE were involved?

    Knowing the work context reveals unsafe steps, missing guards, or improper PPE. It guides corrective actions, retraining, or equipment inspection.

  3. What happened, step by step, and what conditions were present?

    A clear timeline reduces assumptions and bias. Listing surface conditions, lighting, noise, or congestion highlights hazards you can remove.

  4. Who was injured or involved, who witnessed it, and how can we contact them?

    Names, roles, and contact details enable timely follow-up and formal statements. This supports claims processing and coordination with subcontractors.

  5. What immediate actions were taken, and were police or site security notified?

    Documenting first aid, stop-work, lockout, or barricades shows control of the scene and protects others. If the issue relates to theft, trespass, or vandalism, log it with the Security incident report form.

More Forms

Copy/Edit Form Send to Recipients Make a Form w/AI Form Builder Must Ask Questions
  • 100% Free - No Catches
  • Collect Responses Today
  • Tailor to your Look & Feel