Construction Accident Report PDF Details

When an accident, near-miss, or any incident occurs at a construction site, capturing every detail accurately and promptly is crucial for addressing safety concerns and preventing future occurrences. The Construction Accident Report Form serves this vital function, providing a structured method for recording the specifics of the incident. This form encompasses essential fields such as the site name and contact information, details of the person filling out the form, and comprehensive data on the incident itself. It requires information on the injured person, if applicable, including their name, age or date of birth, address, occupation, and employer details. Furthermore, it delves into the accident or incident details, asking for the location, description of what work was being done at the time, and a summary of the event, including injuries sustained. Notably, it prompts for the inclusion of any witnesses, first aid administered, subsequent actions taken to avoid repeat occurrences, and whether safety protocols, like working to a Method Statement or possession of a CSCS card, were followed. This form is not only a tool for recording incidents but also acts as a mechanism to ensure that follow-up actions are documented, emphasizing the importance of learning from each event to foster a safer working environment.

QuestionAnswer
Form Name Construction Accident Report
Form Length 2 pages
Fillable? Yes
Fillable fields 26
Avg. time to fill out 8 min
Other names construction site accident report pdf, construction accident report, construction accident report form template, construction accident report form

Form Preview Example

Accident/Incident Report Form

For Construction Sites

Site Name & Reference:

Site Telephone:

Details of Person completing the Form

Name:

Job Title:

Date:

Accident

Dangerous Occurrence

Near Miss

Illness

Details of the Injured Person

Name of InjuredAge/DOB:

Person:

Address of Injured Person:

Telephone:

 

Occupation:

 

 

 

 

 

Employers Name:

 

 

 

 

 

 

 

Managers Name:

 

Telephone:

 

 

 

 

 

Company Address:

Accident/Incident Details

Location of Accident/Incident (Block/Floor/Plot):

What work was occurring at the time of the accident/incident:

Summary of the accident/incident and the injury caused (part of body and severity): (attached additional pages if necessary)

H:\Developments\SES WH141 Letchworth\Environment\Construction Phase Plan\For SES only\Appendix 10 - Forms; 1 Accident Incident Report Form - Construction.doc

Accident/Incident Report Form

For Construction Sites

Who else was involved? Who witnessed the accident/incident: (state names, employer, contact

details. How the person was involved e.g. banksman, witness etc.)

First Aid Details

Additional Comments

Who was the accident/incident reported to?

What action has occurred since to prevent a reoccurrence?

Is there a Method Statement?

Yes/No

Please attach a copy if relevant

 

 

 

Were they working to the Method

Yes/No

Statement?

 

 

 

Was the injured person inducted?

Yes/No

 

 

 

Card No.:………………………………………………………

Please provide their CSCS Card Details:

Card Type:…………………………………………………….

 

 

 

Please fax this completed form to Stansted Environmental Services Ltd – Fax 01279 873381

For Office Use Only

Accident Category

Follow-up action

H:\Developments\SES WH141 Letchworth\Environment\Construction Phase Plan\For SES only\Appendix 10 - Forms; 1 Accident Incident Report Form - Construction.doc

How to Edit Construction Accident Report Online for Free

The construction site accident report helps manage the site's safety protocols and ensures compliance with health and safety regulations. Below is a step-by-step guide to help you complete this document accurately.

1. Enter Site Information

Write the name and reference number of the site where the incident occurred. Include the site telephone number for direct contact.

2. Provide Your Details

Fill in your name, the date you complete the form, and your job title.

3. Specify the Type of Incident

Check the appropriate box to indicate whether it was an accident, dangerous occurrence, near miss, or illness-related incident.

 

 

construction incident report sample spaces to complete

4. Detail the Injured Person’s Information

Input the injured person's name, age or date of birth, address, and telephone number. Also include their occupation, employer’s, manager’s, and company address.

5. Describe the Accident/Incident

Detail the specific location of the incident (e.g., block, floor, plot) and describe the work being carried out at the time. Include a summary of the accident, the part of the body injured, and the severity of the injury. Attach additional pages if necessary.

Entering details in construction incident report sample part 2

6. Record Witness Information

List the names, employers, and contact details of anyone who witnessed the accident or was involved in the incident. Describe their involvement, such as whether they were a direct witness or played a role.

7. Provide First Aid and Medical Response Details

Record any first aid provided at the scene and the medical response initiated. This part helps in understanding the immediate actions taken after the incident.

part 3 to entering details in construction incident report sample

8. Report Internal Notification

State to whom the accident or incident was reported within the organization and any follow-up actions to prevent a recurrence.

step 4 to entering details in construction incident report sample

9. Confirm Safety Compliance

Indicate whether there was a Method Statement and if it was being followed. Confirm whether the injured person was properly inducted to the site and provide their CSCS card details.

Completing construction incident report sample part 5

10. Mail the Completed Form

Once all sections are filled out, hit the "Done" button. Next, you can export your construction site accident report PDF file — upload it to your device or forward it using email or fax.

Watch Construction Accident Report Video Instruction

Please rate Construction Accident Report

1 Votes
If you believe this page is infringing on your copyright, please familiarize yourself with and follow our DMCA notice and takedown process - click here to proceed .