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Accident Report Log
Keep a historical record of all workplace accidents and injuries with this simple form. Record each accident in order by case number. Additional list key details such as name, location and time of event. Additional reports, statements and analysis can be associated to each other with this log by using the case number. Previous employee accidents can easily be referenced by case, date, location or name by scanning each column.

Free Sample Template
Format: Word PDF
# of Pages: 1
Printable: Yes

Other forms related to workplace accidents
About Employee Accidents
Employee Accident Report
Sample Employee Letter
Accident Analysis Worksheet

Accident Report Log TemplateForm 1012
Format: Word PDF
Category: Employee, Accident
Type: Log

Employee Accident Report Log

Manager’s Name: _______________________________________________________________________________

Year: ___________________

Case #

Employee’s Name

Job Title



Dates Away From Work

Manager’s Signature: ________________________________________________________Date: ___/___/_____