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Accident investigation form

A form for the investigation that follows a significant accident, near miss or dangerous occurrence, carried out by a manager, supervisor or safety adviser. It starts from the reference of the original incident report and adds what that first report does not: the investigation team, the scene with GPS, photos and measurements, the evidence gathered and who holds it, witness interviews, a timed sequence of events, and the immediate, underlying and root causes found with your own method, such as asking why again and again. Review the risk assessment, record the RIDDOR (UK) or OSHA (US) reporting status, and finish with corrective and preventive actions, each with an owner, a due date and a check that it worked.

For managers, supervisors, health and safety advisers and safety representatives investigating an accident or near miss in a warehouse, factory, office, school, healthcare setting or site.

Reporting questions for the UK (RIDDOR 2013) and the US (OSHA 29 CFR 1904.39 and the OSHA 300 Log). For other countries the form asks what had to be reported, to whom and when.

Linked to the original incident report, with the team and the level of investigation
Scene examination with GPS, photos, measurements (measure from photo as an estimate) and the equipment data plate
Evidence log, witness interviews with signatures and a timed sequence of events
Immediate, underlying and root causes, with a why chain if you use 5 whys
RIDDOR or OSHA status with deadline checks, then corrective and preventive actions with verification

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What is an accident investigation form?

It is useful when it goes past the obvious cause. "Operative not paying attention" is where many reports stop; a good investigation asks why the person and the hazard came together, and keeps asking until it reaches something management can change.

Last updated 27 October 2026. Facts checked by the SiteSurvey team on 27 October 2026 against HSE, HSG245 Investigating accidents and incidents, RIDDOR 2013, regulation 4, non-fatal injuries to workers, RIDDOR 2013, Schedule 1 Part 1, reporting procedure, Management of Health and Safety at Work Regulations 1999, regulation 3, risk assessment and OSHA 29 CFR 1904.39, reporting fatalities, hospitalizations, amputations and losses of an eye (eCFR).

How to fill in an accident investigation form

Make the area safe first. Start the investigation as soon as you can, before things are moved or memories fade.

Link it and set the level
Enter the original incident report reference, the date and what happened in brief, then pick the level of investigation from the worst realistic outcome and how likely it is to happen again.
Examine the scene
Capture the GPS position, photograph a wide view then the detail, measure what matters and record the equipment involved. Say what was moved before you got there.
Gather evidence and interview
List each item of evidence and who holds it. Interview witnesses separately, in their own words, and ask them to sign.
Find the causes
Set out the sequence of events, then the immediate, underlying and root causes. Check whether the risk assessment covered what happened.
Report, act and verify
Record the RIDDOR or OSHA status, add corrective and preventive actions with owners and dates, and check each one worked before closing the investigation.

What makes an accident investigation useful

Underlying and root causes

Underlying: peak layout staged roll cages in aisle C, narrowing it to about 1.15 m and putting pickers in the pallet route; dock route blocked. Root: the layout was changed in September without reviewing the risk assessment, and there is no step in the depot procedure to check layout changes for people and pallet routes.

Fictional example. Record the actual evidence and approved arrangements for your job.

A common recording mistake

Writing "human error, retrain operative" as the cause and the action, so the layout that put a picker in a pallet route stays as it is.

What happens next

Give each action an owner and a date, then go back and check it worked, not only that it was done, before closing the investigation.

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Every question in the accident investigation form template

An accident investigation form for the follow-up after a significant accident, near miss or dangerous occurrence: the original incident report reference, the investigation team and level, scene examination with GPS, photos, measurements (measure from photo as an estimate), equipment and Walk Cam film, evidence gathered and who holds it, witness interviews, a timed sequence of events, immediate, underlying and root causes with your own method (5 whys or similar), the risk assessment review, RIDDOR (UK) or OSHA (US) reporting status with deadline checks, corrective and preventive actions with owner, due date and verification, lessons shared and two signatures. 6 sections and 106 questions. Follow-up questions and guidance appear only when an answer calls for them, so the person on site never sees the ones that do not apply.

Make it your own: every question is editable

This is a starting point, not a fixed form. Once it is in your SiteSurvey account you can reword any question, add or remove questions, sections and answer options, and add your own logo, so it fits the way your team works and the jobs you do.

Details you only enter once

Add this form to a project in SiteSurvey and it fills in what the project already knows, so nobody on site retypes it and every form on the job uses the same names. Anything filled in can still be changed.

Project: the project name
Workplace address: the site address, from the space or the project
Client or employer: the project's customer

Investigation details

ProjectShort answer
Filled in from the project in SiteSurvey.
Fills in from the project name
Workplace addressShort answer
Fills in from the site address, from the space or the project
Client or employerShort answer
Fills in from the project's customer
Location (GPS)Short answer
Date the investigation started*Date
Lead investigator*Short answer
Original incident report reference*Short answer
The reference of the first report of the accident or near miss.
Date of the accident or near miss*Date
TimeTime
What is being investigated?*Choose one
- Accident: someone injured
- Accident: ill health
- Near miss: no one hurt
- Dangerous occurrence
- Damage only
Exact location*Short answer
For example aisle C, bay 14, by the sort belt.
CountryChoose one
Sets which reporting questions you see.
- UK (England, Scotland, Wales)
- US (OSHA)
- Other country
What happened, in brief*Notes
As in the original report. The detail goes in the timeline.
Person injured or involvedShort answer
Initials, job and employer. Personal details stay on the original report.
Shown only when the answers above make it relevant
Injury or ill health, as recordedShort answer
Shown only when the answers above make it relevant
Days unable to do their normal work so farNumber
Consecutive days, not counting the day of the accident.
Shown only when the answers above make it relevant
Worst realistic outcome*Choose one
What could have happened, not only what did.
- Fatal
- Major
- Serious
- Minor
Could it happen again?*Choose one
- Certain
- Likely
- Possible
- Unlikely
- Rare
Level of investigation*Choose one
Minimal: the supervisor looks into it. Low: a short investigation by the supervisor or line manager. Medium: more detail, with the health and safety adviser and employee representatives. High: a team, overseen by senior management or directors.
- Minimal
- Low
- Medium
- High
CheckThis is the follow-up investigation of an accident, near miss or dangerous occurrence that has already been reported. Keep the original incident report: this record adds the evidence, the causes and the actions.
GuidanceHSE's guide HSG245, Investigating accidents and incidents, takes you through four steps: gathering the information, analysing it, identifying risk control measures, and the action plan and its implementation. Pages 2 to 6 follow those steps. It suggests the level of investigation from the worst realistic outcome and how likely it is to happen again.
Investigation team
Repeat for each team member. Each one asks:
- Name*Short answer
- RoleChoose one
  - Supervisor or line manager
  - Health and safety adviser
  - Employee or safety representative
  - Senior manager or director
  - Specialist
  - Other

Scene examination

Was the scene made safe and left as it was until it was examined?*Yes or No
What was moved or changed before the examination, and why?Notes
Shown when “Was the scene made safe and left as it was until it was examined?” is No
Scene location (GPS)Short answer
Conditions at the timeTick all that apply
- Poor lighting
- Wet or slippery floor
- Uneven or damaged floor
- Obstruction or clutter
- Congested area or vehicle traffic
- Noise
- Heat or cold
- Weather
- Busy period or time pressure
- None of these
What the scene showsNotes
Layout, positions of people, equipment and materials.
Scene photosPhotos
A wide view first, then the detail. Photograph before anything is moved.
Measurements
Repeat for each measurement. Each one asks:
- What was measured*Short answer
  For example clear width of the aisle, height of the step.
- MeasurementNumber
- UnitChoose one
  - mm
  - cm
  - m
  - in
  - ft
- How measuredChoose one
  - Tape or laser
  - Measured from a photo (estimate)
  - From a drawing
Was any equipment, vehicle or tool involved?*Yes or No
EquipmentShort answer
Type and fleet or asset number.
Shown when “Was any equipment, vehicle or tool involved?” is Yes
Equipment data plateScan a label: asset number, make and model, serial number, rated capacity
Optional. Scan the data plate or label to capture the numbers.
Shown when “Was any equipment, vehicle or tool involved?” is Yes
Taken out of use and labelled until it has been checked?Yes or No
Shown when “Was any equipment, vehicle or tool involved?” is Yes
Condition found when checkedNotes
Shown when “Was any equipment, vehicle or tool involved?” is Yes
Equipment photosPhotos
Shown when “Was any equipment, vehicle or tool involved?” is Yes
Scene walk-round filmWalk Cam video with voice-to-text
Optional. Film a guided walk-round on the SiteSurvey app.

Evidence and witness interviews

Evidence gathered
Repeat for each evidence. Each one asks:
- Type*Choose one
  - Photo or video
  - CCTV footage
  - Equipment or part
  - Document or record
  - Training record
  - Risk assessment or safe system of work
  - Maintenance or inspection record
  - Other
- Description*Short answer
- Who holds itShort answer
- Where it is keptShort answer
- PhotoPhotos
Items of evidenceWorked out by the form
Were there witnesses, or people who know the conditions?*Yes or No
Witness interviews
Repeat for each interview. Each one asks:
Shown when “Were there witnesses, or people who know the conditions?” is Yes
- Name*Short answer
- Who are they?Choose one
  - Injured person
  - Employee
  - Supervisor or manager
  - Contractor or agency worker
  - Visitor or member of the public
- Interviewed onDate
- Interviewed byShort answer
- Where they were and what they could seeShort answer
- Their account*Notes
  In their own words, facts first. Note anything they are unsure of.
- Signature of the person interviewedSignature
InterviewsWorked out by the form
Shown when “Were there witnesses, or people who know the conditions?” is Yes

Sequence of events and causes

Sequence of events
Repeat for each step. Each one asks:
- TimeTime
- What happened*Short answer
Where were the immediate causes?Tick all that apply
- The place: layout, floor, lighting, access
- The plant or equipment
- The people: actions, training, fitness
- The process: task, method, pace
Immediate causes*Notes
The most obvious reasons it happened, for example the guard was missing or the person slipped.
Underlying causes*Notes
The less obvious system or organisational reasons, for example checks not done, or the hazard not in the risk assessment.
Root causes*Notes
The failing the others grew from, usually in management, planning or organisation.
How were the causes found?Choose one
- Asking why, again and again (5 whys)
- Cause and effect diagram
- Events and causal factors chart
- Our own method
- Other
Which method?Short answer
Shown only when the answers above make it relevant
Why chain
Repeat for each why. Each one asks:
Shown only when the answers above make it relevant
- Why?*Short answer
- Because*Short answer
Was there a risk assessment for this work?*Choose one
- Yes
- No
- Not known
Risk assessment referenceShort answer
Shown when “Was there a risk assessment for this work?” is “Yes”
Did it cover what happened?Choose one
- Yes, and the controls were followed
- Yes, but the controls were not followed
- Yes, but the controls were not enough
- No, the hazard was not covered
Shown when “Was there a risk assessment for this work?” is “Yes”
Has the risk assessment been reviewed after this investigation?Yes or No
Shown when “Was there a risk assessment for this work?” is “Yes”
What changed in itNotes
Shown when “Has the risk assessment been reviewed after this investigation?” is Yes
GuidanceUK: a risk assessment must be reviewed if there is reason to suspect it is no longer valid, or there has been a significant change (Management of Health and Safety at Work Regulations 1999, regulation 3(3)).
Shown when “Country” is “UK (England, Scotland, Wales)” and “Was there a risk assessment for this work?” is “Yes”
WarningNo risk assessment is recorded for this work. Make one before the work starts again.
Shown when “Was there a risk assessment for this work?” is “No”
WarningLikely to happen again. Put interim controls in place now, before the actions are complete.
Shown only when the answers above make it relevant

Reporting

GuidanceRIDDOR 2013. Deaths, specified injuries to workers, injuries to people not at work who are taken to hospital, and dangerous occurrences: notify the enforcing authority without delay by the quickest practicable means, and send a report within 10 days (10 working days for a few classes of dangerous occurrence). An injury that stops a worker doing their normal work for more than seven consecutive days, not counting the day of the accident, must be reported within 15 days of the accident. Keep a record of reportable incidents, and of injuries that keep a worker off normal work for more than three consecutive days, for at least three years.
Shown when “Country” is “UK (England, Scotland, Wales)”
RIDDOR category*Choose one
- Not reportable
- Death
- Specified injury to a worker
- Over-7-day injury to a worker
- Person not at work taken to hospital
- Dangerous occurrence
- Occupational disease
- Not sure yet
Shown when “Country” is “UK (England, Scotland, Wales)”
WarningDays off normal work is more than seven. That is reportable under RIDDOR as an over-7-day injury. Check the category.
Shown only when the answers above make it relevant
CheckCheck with your health and safety adviser now. The deadlines run from the date of the accident.
Shown when “Country” is “UK (England, Scotland, Wales)” and “RIDDOR category” is “Not sure yet”
Has it been reported?Yes or No
Shown only when the answers above make it relevant
Date reportedDate
Shown when “Country” is “UK (England, Scotland, Wales)” and “Has it been reported?” is Yes
Report referenceShort answer
Shown when “Country” is “UK (England, Scotland, Wales)” and “Has it been reported?” is Yes
Days from the accident to the reportWorked out by the form
Shown when “Country” is “UK (England, Scotland, Wales)” and “Has it been reported?” is Yes and “Date of the accident or near miss” is answered and “Date reported” is answered
CheckReported more than 10 days after the incident. For this category the report is due within 10 days (10 working days for a few dangerous occurrences). Record the reason.
Shown only when the answers above make it relevant
CheckReported more than 15 days after the accident. Over-7-day injuries must be reported within 15 days. Record the reason.
Shown only when the answers above make it relevant
Reason for the delayNotes
Shown only when the answers above make it relevant
WarningNot reported yet. Report it now.
Shown when “Country” is “UK (England, Scotland, Wales)” and “Has it been reported?” is No
GuidanceOSHA 29 CFR 1904.39. Report a work-related fatality to OSHA within 8 hours, and an in-patient hospitalization, amputation or loss of an eye within 24 hours: by phone or in person to the nearest Area Office, by phone to 1-800-321-OSHA (1-800-321-6742), or online at osha.gov. If you keep OSHA injury records, enter each recordable injury on the OSHA 300 Log and 301 Incident Report within 7 calendar days of learning of it (1904.29).
Shown when “Country” is “US (OSHA)”
OSHA severe injury reporting*Choose one
- Not reportable to OSHA
- Fatality
- In-patient hospitalization
- Amputation
- Loss of an eye
- Not sure yet
Shown when “Country” is “US (OSHA)”
Has it been reported to OSHA?Yes or No
Shown only when the answers above make it relevant
Date and time reportedShort answer
Shown when “Country” is “US (OSHA)” and “Has it been reported to OSHA?” is Yes
HowChoose one
- Phone or in person to the Area Office
- OSHA toll-free number
- Online at osha.gov
Shown when “Country” is “US (OSHA)” and “Has it been reported to OSHA?” is Yes
ReferenceShort answer
Shown when “Country” is “US (OSHA)” and “Has it been reported to OSHA?” is Yes
WarningNot reported yet. Report it now: the time limit runs from the incident.
Shown when “Country” is “US (OSHA)” and “Has it been reported to OSHA?” is No
OSHA 300 LogChoose one
- Entered
- Not recordable
- Not required to keep OSHA records
- Not yet
Shown when “Country” is “US (OSHA)”
Reporting in your countryNotes
What had to be reported, to whom, and when it was done.
Shown when “Country” is “Other country”
Has the original incident report been updated with what the investigation found?Yes or No
Who else has been told?Tick all that apply
- The injured person
- Their employer
- Safety representative
- Insurer
- Client or principal contractor
- Senior management

Actions, lessons and sign-off

Actions recordedWorked out by the form
ResultWorked out by the form
Corrective and preventive actions
Repeat for each action. Each one asks:
- Action*Notes
- Type*Choose one
  - Corrective: puts this right
  - Preventive: stops it happening again
- Cause it deals withChoose one
  - Immediate
  - Underlying
  - Root
- PriorityChoose one
  - Immediate: before the work restarts
  - Within a week
  - Within a month
  - Longer term
- Who will do it*Short answer
- Due byDate
- Status*Choose one
  - Open
  - In progress
  - Done, checked
- How it was checkedNotes
  What you saw that shows it works, not only that it was done.
  Shown when “Status” is “Done, checked”
- Checked byShort answer
  Shown when “Status” is “Done, checked”
- Date verifiedDate
  Shown when “Status” is “Done, checked”
- Photo when donePhotos
  Shown when “Status” is “Done, checked”
Actions still openWorked out by the form
Decision*Choose one
- Investigation closed: all actions done and verified
- Investigation complete: actions in progress
- Further investigation needed
WarningActions are still open, but the investigation is marked closed. Finish and verify the actions, or choose another decision.
Shown only when the answers above make it relevant
Date to review the actionsDate
How the lessons were sharedTick all that apply
- Team briefing or toolbox talk
- Safety committee
- Other sites or depots
- Safety alert or bulletin
- Training updated
- Not yet
Lessons learnedNotes
Summary of the findingsNotes
Lead investigator nameShort answer
Lead investigator signature*Signature
Manager responsible nameShort answer
Manager responsible signatureSignature

See it filled in

A completed accident investigation form report, made by SiteSurvey from a fictional site visit: every answer, the photos, the guidance that applied and the sign-off, ready to send as a PDF.

See completed form (PDF) ↗

Accident investigation form FAQs

What is the difference between an incident report and an accident investigation?

The incident report is the first record, made soon after the event: what happened, who was involved and any injury. The investigation comes after and goes deeper: the scene, evidence, interviews, the causes and the actions to stop it happening again. This form starts from the incident report's reference so the two stay linked. SiteSurvey has an incident report template for the first record.

What are the steps of an accident investigation?

HSE's guide HSG245, Investigating accidents and incidents, sets out four steps: gathering the information, analysing the information, identifying risk control measures, and the action plan and its implementation. It also suggests a minimal, low, medium or high level of investigation, based on the worst potential outcome and how likely the event is to happen again. The form follows the same order.

Source: HSE, HSG245 Investigating accidents and incidents.

What are immediate, underlying and root causes?

HSG245 describes the immediate cause as the most obvious reason an adverse event happens, such as a missing guard or a slip. Underlying causes are the less obvious system or organisational reasons, such as checks not being done or a hazard not covered by the risk assessment. A root cause is the failing from which the others spring, usually in management, planning or organisation. HSG245 uses asking "why" again and again, and says you can choose the method that suits you.

Source: HSE, HSG245 Investigating accidents and incidents.

When must an accident be reported under RIDDOR?

Under RIDDOR 2013, deaths, specified injuries to workers, injuries to people not at work who are taken to hospital, and dangerous occurrences must be notified without delay and reported within 10 days. An injury that stops a worker doing their normal work for more than seven consecutive days, not counting the day of the accident, must be reported within 15 days of the accident. The form works out the days from the accident to the report and warns if it was late.

Sources: RIDDOR 2013, regulation 4, non-fatal injuries to workers and RIDDOR 2013, Schedule 1 Part 1, reporting procedure.

What has to be reported to OSHA?

Under 29 CFR 1904.39, employers must report a work-related fatality to OSHA within 8 hours, and an in-patient hospitalization, amputation or loss of an eye within 24 hours, by phone or in person to the nearest Area Office, by phone to OSHA's toll-free number, or online. The form records the category, when and how it was reported, and whether the case is on the OSHA 300 Log.

Source: OSHA 29 CFR 1904.39, reporting fatalities, hospitalizations, amputations and losses of an eye (eCFR).

Does the risk assessment need reviewing after an accident?

In Great Britain, a risk assessment must be reviewed if there is reason to suspect it is no longer valid or there has been a significant change, and changed where needed (Management of Health and Safety at Work Regulations 1999, regulation 3(3)). An accident is often that reason. The form asks whether there was an assessment, whether it covered what happened, and what changed in it.

Source: Management of Health and Safety at Work Regulations 1999, regulation 3, risk assessment.

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