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Critical Incident Report Form

Critical Incident Report Form Template for India

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Key Requirements PROMPT example:

Critical Incident Report Form

"I need a Critical Incident Report Form for our manufacturing facility in Mumbai that complies with Indian factory safety regulations, with special emphasis on machinery accidents and chemical spills, and includes automated notification to our regional safety officers."

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Document background
The Critical Incident Report Form serves as an essential documentation tool for organizations operating in India, designed to capture detailed information about significant workplace incidents, accidents, or near-misses. This document is mandatory under various Indian regulations, including the Occupational Safety, Health and Working Conditions Code, 2020, and state-specific factory rules. It must be completed immediately following any critical incident to ensure accurate documentation of events, actions taken, and parties involved. The form supports multiple purposes including legal compliance, insurance claims, worker compensation cases, and organizational learning. It helps organizations maintain proper records for regulatory inspections while providing crucial data for implementing preventive measures and improving safety protocols.
Suggested Sections

1. Incident Identifier: Unique reference number, date, time, and location of the incident

2. Reporter Details: Name, position, contact information of the person reporting the incident

3. Incident Classification: Category and severity level of the incident

4. Incident Description: Detailed account of what happened, including sequence of events

5. Persons Involved: Details of all individuals involved, including victims, witnesses, and responders

6. Immediate Actions Taken: Steps taken immediately after the incident to secure safety and contain the situation

7. Injuries/Damages: Description of any injuries to persons or damage to property/equipment

8. Notifications Made: List of authorities, management, and other stakeholders notified of the incident

9. Initial Risk Assessment: Evaluation of immediate risks and hazards following the incident

Optional Sections

1. Environmental Impact: Assessment of environmental effects - required for incidents involving spills, releases, or environmental damage

2. Equipment/Machinery Involved: Detailed information about equipment involved - required for technical/mechanical incidents

3. Medical Response Details: Specific medical interventions and treatment provided - required for incidents involving injuries

4. Security Breach Details: Information about security violations - required for incidents involving theft, unauthorized access, or security threats

5. Media/Public Relations Impact: Assessment of public relations implications - required for incidents with potential media attention

6. Business Continuity Impact: Effect on business operations - required for incidents affecting operational continuity

7. Third Party Involvement: Details of external parties involved - required when contractors, visitors, or public are involved

Suggested Schedules

1. Witness Statements: Formal statements from witnesses, attached as separate documents

2. Photo Documentation: Photographs, videos, or visual evidence of the incident and its effects

3. Site Diagram/Floor Plan: Marked diagram showing incident location and relevant details

4. Risk Assessment Forms: Completed risk assessment documentation

5. Equipment/Machinery Reports: Technical reports or maintenance records of involved equipment

6. Medical Reports: Copies of relevant medical documentation (with appropriate privacy protections)

7. Investigation Checklist: Standard checklist for ensuring complete incident investigation

8. Incident Classification Guide: Reference guide for standardized incident classification

9. Regulatory Reporting Requirements: Checklist of mandatory reporting requirements based on incident type

Authors

Alex Denne

Head of Growth (Open Source Law) @ ¶¶Òõ¶ÌÊÓƵ | 3 x UCL-Certified in Contract Law & Drafting | 4+ Years Managing 1M+ Legal Documents | Serial Founder & Legal AI Author

alex.den.21@genieai.co
Relevant legal definitions








































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Relevant Industries

Manufacturing

Healthcare

Construction

Information Technology

Education

Transportation

Mining

Chemical Processing

Pharmaceuticals

Retail

Hospitality

Energy and Utilities

Financial Services

Telecommunications

Logistics and Warehousing

Relevant Teams

Health and Safety

Operations

Human Resources

Risk Management

Security

Emergency Response

Quality Assurance

Compliance

Production

Facilities Management

Environmental Health

Senior Management

Legal

Training and Development

Internal Audit

Relevant Roles

Health and Safety Manager

Facility Manager

Department Supervisor

Security Officer

Risk Management Director

Operations Manager

Human Resources Manager

Quality Assurance Manager

Shift Supervisor

Plant Manager

Emergency Response Coordinator

Compliance Officer

Environmental Health Officer

Production Supervisor

Site Safety Coordinator

Industries








Teams

Employer, Employee, Start Date, Job Title, Department, Location, Probationary Period, Notice Period, Salary, Overtime, Vacation Pay, Statutory Holidays, Benefits, Bonus, Expenses, Working Hours, Rest Breaks,  Leaves of Absence, Confidentiality, Intellectual Property, Non-Solicitation, Non-Competition, Code of Conduct, Termination,  Severance Pay, Governing Law, Entire Agreemen

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