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Incident Investigation Form
1. Incident Identification Details: Basic information including date, time, location, and type of incident
2. Involved Parties: Information about all persons involved in the incident, including affected individuals, witnesses, and investigators
3. Initial Incident Description: Immediate factual account of what occurred, before detailed investigation
4. Investigation Process: Documentation of investigation methodology, interviews conducted, and evidence collected
5. Root Cause Analysis: Detailed analysis of direct and underlying causes of the incident
6. Impact Assessment: Evaluation of actual and potential consequences including injuries, property damage, and operational impacts
7. Immediate Actions Taken: Description of emergency response and immediate corrective actions implemented
8. Preventive Measures: Recommended and implemented measures to prevent recurrence
9. Compliance Review: Assessment of compliance with relevant regulations and internal procedures
10. Sign-off and Verification: Signatures of investigators, reviewers, and relevant authorities
1. Environmental Impact: Required when incident involves environmental releases or impacts
2. Equipment/Machinery Analysis: Detailed when incident involves equipment failure or malfunction
3. Third-Party Investigation Findings: Include when external investigators or authorities are involved
4. Cost Analysis: Optional section for calculating direct and indirect costs of the incident
5. Media and Communications Plan: Required for major incidents with potential public interest
6. Insurance and Claims Information: Include when incident may result in insurance claims
7. Training Review: Analysis of training adequacy when human error is a factor
1. Appendix A - Witness Statements: Detailed accounts from witnesses and involved parties
2. Appendix B - Photographic Evidence: Photos, videos, or visual documentation of the incident scene
3. Appendix C - Technical Reports: Detailed technical analyses, test results, or expert reports
4. Appendix D - Risk Assessment: Updated risk assessment following the incident
5. Appendix E - Incident Timeline: Detailed chronological sequence of events
6. Appendix F - Investigation Checklist: Completed investigation procedure checklist
7. Appendix G - Regulatory Reporting Forms: Copies of mandatory reports submitted to authorities
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