Incident Investigation Form
 
Look past the immediate cause of an incident to find out why it happened, then set corrective actions so it does not happen again.
 
What's included
Section 1: what happened and the evidence gathered
Section 2: a timeline of events
Section 3: contributing factors to tick
Section 4: a 5 Whys analysis to find the root cause
Section 5: corrective actions using the hierarchy of controls
Section 6: sign-off and review
A one-page instruction sheet with step-by-step guidance and tips
 
When to use it
After an incident report, for any serious incident or near miss
When the same type of incident keeps happening
When a regulator or client asks how an incident was investigated
 
Make it yours
Fully editable in Microsoft Word. Add your logo, change any item to suit your workplace, and print it or use it on screen. Review it with your workers before you start using it.