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Safety Incident Report · Popular

Construction Site Slip, Trip & Fall Incident Report Form

Quickly capture and document slip, trip, and fall incidents on construction sites including injury details, location, and contributing factors.

Use This Template Free Preview

Cloud theme

formbuilder.ai/f/construction-site-slip-trip-fall-safety-incident-report-form

Construction Site Slip, Trip & Fall Safety Incident Report Form

Report / Reference Number

· · ·

Name of Person Completing This R

· · ·

Reporter's Email Address

· · ·

Submit

The Construction Site Slip, Trip & Fall Safety Incident Report Form is a comprehensive tool designed to help site managers, safety officers, and supervisors accurately document fall-related incidents the moment they occur. It captures critical information including incident location, weather conditions, time of occurrence, and a detailed description of how the incident unfolded.

This form is essential for construction companies, subcontractors, and project managers who need to maintain regulatory compliance and uphold workplace safety standards. By recording injured person details, employment status, PPE usage, and primary contributing factors, teams can identify hazards and implement corrective measures to prevent future incidents.

Using a standardized digital form streamlines the reporting process, reduces paperwork errors, and ensures all relevant data is captured consistently across every job site. Start using this free template today to strengthen your safety culture and protect your workforce.

4 Pages

35 Questions

~12min To complete

Free No credit card needed

Field types Single Choice ×7 Short Text ×6 Dropdown ×5 Long Text ×4 Full Name ×3 Phone ×2 Date ×2 Email Time Picker Multiple Choice File Upload termsandconditions Signature

Questions in this template

Free template

The exact questions included — customize any of them to fit your needs.

Page 1 Incident Overview 9 questions

Incident Overview

1 Report / Reference Number Short Text

2 Name of Person Completing This Report * Full Name

3 Reporter's Email Address * Email

4 Reporter's Phone Number * Phone

5 Reporter's Role on Site * Dropdown

6 Date of Incident * Date

7 Time of Incident * Time Picker

8 Exact Location on Construction Site (e.g., Level 3 stairwell, loading dock) * Short Text

9 Weather Conditions at Time of Incident * Dropdown

Page 2 Injured Person & Incident Details 8 questions

Injured Person Details

1 Full Name of Injured Person * Full Name

2 Employment Status of Injured Person * Dropdown

3 Employer / Subcontractor Company Name * Short Text

4 Injured Person's Contact Number * Phone

Incident Details

5 Type of Incident * Single Choice

6 Detailed Description of How the Incident Occurred * Long Text

7 Primary Contributing Factor * Dropdown

8 Was Personal Protective Equipment (PPE) Being Worn? * Multiple Choice

Page 3 Injury & Medical Response 10 questions

Injury & Medical Response

1 Was the Person Injured? * Single Choice

2 Type of Injury Sustained * Dropdown

3 Body Part(s) Affected * Short Text

4 Severity Level * Single Choice

5 Was First Aid Administered on Site? * Single Choice

6 Name of First Aider (if applicable) Short Text

7 Was the Injured Person Taken to a Hospital or Medical Facility? * Single Choice

8 Hospital / Medical Facility Name (if applicable) Short Text

Evidence & Documentation

9 Upload Photos of the Incident Scene, Hazard, or Injury File Upload

10 Witness Names and Contact Details (if any) Long Text

Page 4 Corrective Actions & Sign-Off 8 questions

Immediate Actions Taken

1 Describe Immediate Corrective Actions Taken After the Incident * Long Text

2 Was the Area Barricaded or Secured After the Incident? * Single Choice

3 Has the Incident Been Reported to the Relevant Safety Authority (e.g., OSHA, HSE)? * Single Choice

Follow-Up & Preventive Measures

4 Recommended Preventive Measures to Avoid Recurrence * Long Text

5 Site Safety Officer / Manager Reviewing This Report * Full Name

6 Date of Review * Date

7 I confirm that the information provided in this report is accurate and complete to the best of my knowledge. * termsandconditions

8 Signature of Person Completing This Report * Signature

How to use this template

Click "Use This Template Free" to open it in the FormBuilder editor. From there you can add, remove, or reorder fields with drag-and-drop, switch themes for instant restyling, add your logo, configure email notifications, and set your success message. When ready, publish with a unique link and start collecting responses immediately.