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Incident Investigation Report Form — Free Printable Template

This form follows the four steps and the report sections of OSHA's own incident investigation guide: preserve and document the scene, collect information, determine the root causes, implement corrective actions. It has no field for who was at fault, because the guide is explicit that an investigation looking for fault stops before it reaches the root cause. Fill it in, print it, or download the PDF. Nothing you type is sent to our servers.

Reporting to OSHA runs on its own clock, and it starts now. A work-related fatality is reported within 8 hours; an in-patient hospitalization, an amputation or the loss of an eye within 24 hours — 29 CFR 1904.39(a). Step 1 below carries the eight items OSHA asks for when you call. The investigation does not wait for the report, and the report does not wait for the investigation.

OSHA's guide defines an incident as an event in which an injury or ill health occurred or could have occurred.
By phone or in person to the nearest Area Office, on the 800 number, or through the reporting application on osha.gov — 1904.39(a)(3).
Leave blank or use an identifier for a privacy concern case — 1904.29(b)(7).
Where a staffing agency worker is involved, OSHA's guide asks both the host employer and the agency to investigate.
The guide asks that interviews be conducted in the language of the person, with a translator if needed.
OSHA recommends a team of management and workers rather than a lone supervisor.
Evidence preserved and collected — step 1 and step 2 of the guide

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Template for informational purposes only. This document must be reviewed and adapted by a competent or qualified person for your specific jobsite, equipment, and applicable federal, state, and local requirements. It does not constitute legal, engineering, or safety advice and does not by itself establish compliance with OSHA or any other standard. SteelToeTools assumes no liability for its use. Nothing you type is sent to our servers.

How to use this form

  1. 1
    Deal with the emergency, then secure the scene. OSHA's guide puts one line above everything else: before investigating, all emergency response needs must be completed and the site must be safe and secure for entry. Then preserve it — cones, tape, a guard — before the crew tidies up, because the cleanup is what usually destroys the evidence.
  2. 2
    Start the reporting clock separately. A fatality goes to OSHA within 8 hours; an in-patient hospitalization, an amputation or a loss of an eye within 24. That report is eight facts on the phone, not the investigation. Step 1 of the form records that you made it, and when.
  3. 3
    Interview while memories are fresh, in the person's language. Say plainly that the purpose is fact-finding, not fault-finding. Let people tell it their way without interrupting, then ask the clarifying questions. Ask each person what they think would have prevented it — it is the single most productive question on the sheet.
  4. 4
    Ask why until you reach something you can change. The five lines in step 3 are there to stop the report at a decision, not at a person. If the last answer is still about what somebody did, you have another why to ask.
  5. 5
    Answer every factor you checked with an action, at the highest level of control you can reach. Elimination, substitution and engineering before administrative controls and PPE. An investigation that ends in “retrain the crew” and nothing else has usually found the immediate cause and stopped.
  6. 6
    Give the actions an owner, a date and a verification. Then close the report only when someone has checked that the control is in place and working — and tell the crews what came out of it. A workforce that never hears the outcome stops reporting close calls.

What OSHA requires — and what it only recommends

This distinction matters, because a lot of forms on the internet blur it. No federal OSHA standard requires you to investigate an incident, and none prescribes an investigation form. What the rules do require is the reporting of the worst outcomes and the recording of the countable ones. The investigation is what OSHA recommends — in Recommended Practices for Safety and Health Programs, and in the December 2015 employer guide whose four steps and report sections this form follows — and what your general contractor, your insurer, your process safety program or your state plan is likely to require of you by their own rules.

The rules that do apply after an incident
The requirementSource
Report a work-related fatality to OSHA within 8 hours; report an in-patient hospitalization, an amputation or the loss of an eye within 24 hours1904.39(a)(1)-(2)
Report by telephone or in person to the nearest Area Office, on 1-800-321-OSHA, or through the reporting application on osha.gov — not by voicemail, fax or email1904.39(a)(3), (b)(1)
Give OSHA eight things: establishment name, location of the incident, time of the incident, type of event, number of employees affected, their names, your contact person and phone number, and a brief description1904.39(b)(2)
A fatality is reportable only if it occurs within 30 days of the incident; a hospitalization, amputation or eye loss only if it occurs within 24 hours of the incident — but the case is still recorded1904.39(b)(6)
In-patient hospitalization means a formal admission for care or treatment — observation or diagnostic testing alone is not reportable1904.39(b)(9)-(10)
Enter each recordable case on the OSHA 300 Log and complete a 301 Incident Report, or an equivalent form, within seven calendar days of learning of it1904.29(b)(2)-(3)
Keep a reasonable procedure for employees to report injuries and illnesses promptly — a procedure that would deter a reasonable employee from reporting is not reasonable — and tell every employee what it is1904.35(b)(1)(i)-(iii)
Do not discharge or discriminate against an employee for reporting a work-related injury or illness; section 11(c) protections apply1904.35(b)(1)(iv), 1904.36
Keep the 300 Log, the annual summary, the privacy case list and the 301 Incident Reports for five years after the end of the calendar year they cover1904.33(a)
Construction employers must run an accident prevention program with frequent and regular inspections by competent persons — the loop this report feeds1926.20(b)(1)-(2)

Investigate programs, not behaviors

The sentence that shapes this form is OSHA's, not ours: “Under a systems approach, one would not conclude that carelessness or failure to follow a procedure alone was the cause of an incident.” The guide is blunt about why — an investigation understood as a search for someone to blame makes both workers and managers guarded, and it stops at the first explanation that assigns fault, which is always the last link in the chain and never the one you can fix. That is why this form has no fault field, why the contributing factors are all written as statements about programs and conditions, and why the corrective action table asks for a level of control rather than a promise to be more careful.

State plan states may go further than the federal rules above — Washington, for example, requires construction employers to hold crew safety meetings weekly and to evaluate accident investigations at them (WAC 296-155-110(6)(c)). Check the rules of the state you work in.

Frequently asked questions

No federal standard orders you to investigate an incident or to use any particular form. What the rules require is the reporting and the recording: a work-related fatality goes to OSHA within 8 hours and an in-patient hospitalization, amputation or loss of an eye within 24 hours under 1904.39, and a recordable case goes on the 300 Log and a 301 Incident Report within seven calendar days under 1904.29(b)(3). The investigation itself is what OSHA recommends, in the guide this form is built from, and what almost every general contractor, insurer and process safety program requires by contract.

The 301 records the case. It asks who was hurt, what happened, what the injury was, and what was being done at the time, so the case can be counted. This form asks why it happened and what is being changed. They are not substitutes: you still complete a 301 or an equivalent form for every recordable case, and the investigation report sits alongside it.

Because OSHA's guide says an investigation focused on finding fault will always stop short of the root cause, and because people stop talking when they think the form is looking for someone to blame. The guide's own words are that the goal is to understand how and why the existing barriers against the hazard failed, not to find someone to blame. The form asks what the programs did instead — the procedure, the training, the equipment, the supervision, the schedule.

Yes. OSHA calls them close calls and defines an incident as an event in which an injury or ill health occurred or could have occurred. A close call is the same event without the injury, which makes it the cheapest information you will ever get. If you want a short form for workers to file the report in the first place, use the near miss report generator; use this one for the investigation that follows.

Until the answer is something you can change. "The worker was in a hurry" is not a root cause; "the crew is measured on units per shift and the only place to buy back time is the setup" is, because it names a management decision. OSHA's guide puts it as asking why repeatedly, and warns that conclusions like careless or failed to follow the procedure are where a bad investigation stops.

OSHA recommends a team rather than a lone supervisor, with managers and workers together, because each brings different knowledge and because a shared conclusion is a conclusion people act on. On a multi-employer site the investigation should be shared with each employer, and where a staffing agency worker is involved, both the host employer and the agency should investigate.

There is no federal retention period for an investigation report. The related records do have one: the 300 Log, the annual summary, the privacy case list and the 301 Incident Reports are kept five years past the end of the calendar year they cover, under 1904.33. Most programs keep the investigation for at least as long, and longer where a claim or a contract requires it.

No. The report is built in your browser and the PDF is generated on your device. A draft stays in this browser until you clear it.

Sources & references

Content checked against these sources — last reviewed September 14, 2026.

By — Editorial team of SteelToeTools.com (published by LSEA SAS) Updated v1