Employee Injury Report Form Template

Description

Injuries and near misses happen in our line of work, from slips on wet floors to strained backs and cuts on broken glass. ThisEmployee Injury Report Form gives you a structured way to document every work-related injury or near miss so you can spot patterns, fix hazards, and protect your business. Modeled after the form Serene Clean uses with its own team, it turns a reactive scramble into a documented, professional process.

Built for cleaning company owners who want a clear, consistent way to document workplace incidents, this one-page form captures every detail management needs to investigate, follow up, and reduce future risk.

What this template does for your team

• Captures work-related injuries, illnesses, and near misses in a single consistent format
• Documents all the important and nuanced details of every incident
• Prompts employees to think about prevention on the spot, not just describe the incident
• Records treatment and follow-up details when a physician is involved

What’s inside

 An injury report form covering employee details, incident type, witnesses, step-by-step description of what happened, prevention suggestions and more.

Built for residential, commercial, and vacation-rental cleaning companies.

Part of the Employee Policies & HR Bundle.

This template is provided for educational and operational use. Review and customize it for your company’s policies before use.