Report an incident with the details of what happened.
Business template · 14 fields (11 required) · ~3 min for respondents to complete · Free plan · No credit card · Fully customizable
Set up your incident report form
Report an incident with the details of what happened.
Ask staff to file this as soon as possible after an incident, even if no one was hurt. Call emergency services first for anything urgent; this form is for records and follow-up.
The form separates phone number (optional), date of incident, time of incident, location of incident into labeled questions. Review the choices and required fields for your organization before sharing it.
Best practices
Ask staff to file this as soon as possible after an incident, even if no one was hurt. Call emergency services first for anything urgent; this form is for records and follow-up.
Customize the phone number (optional) and date of incident questions to match your records and terminology.
Name the team that reviews responses and explain what happens after submission. A requested date, service or approval is not automatically confirmed.
Keep uploads limited to relevant supporting material. Use your approved private process for sensitive records and verify response access before sharing.
Every field, explained
Name of person reporting (Name, required)
Email address (Email, required)
Phone number (optional) (Phone)
Date of incident (Date, required)
Time of incident (Time, required)
Location of incident (Short text, required)
Type of incident (Dropdown, required)
Describe what happened (Long text, required)
Was anyone injured? (Single choice, required)
Was medical treatment needed? (Single choice, required)
Names of people involved or witnesses (optional) (Long text) — Include contact details for witnesses if you have them.
Immediate actions taken (Long text, required)
Photos of the scene or damage (optional) (File upload)
Confirmation (Multiple choice, required)
Frequently asked questions
What does this incident report form template collect?
Alongside contact details, it asks for phone number (optional), date of incident, time of incident, location of incident, type of incident, describe what happened, was anyone injured?, was medical treatment needed?, names of people involved or witnesses (optional), immediate actions taken, photos of the scene or damage (optional), confirmation. You can rename questions, change choices and remove fields that your workflow does not need.
How should I use this incident report form form?
Ask staff to file this as soon as possible after an incident, even if no one was hurt. Call emergency services first for anything urgent; this form is for records and follow-up.
Can I edit this form and print a copy?
Yes. Open an editable draft, adjust the questions, and review the preview before publishing. You can also use the template page’s print option. Publishing requires an account; the draft can be tried first.