Fire Incident Report Form

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Fire Incident Report Form

A fire incident report documents when a fire happens in a building or when smoke detection systems are set off. It may be used by landlords, property managers, and business owners to keep their own record of such events and their particular details. It’s recommended that photo evidence be attached to the report as evidence of how the incident started.

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Last updated August 21st, 2025

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A fire incident report documents when a fire happens in a building or when smoke detection systems are set off. It may be used by landlords, property managers, and business owners to keep their own record of such events and their particular details. It’s recommended that photo evidence be attached to the report as evidence of how the incident started.

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When to Use

  • A fire occurred on the property
  • Smoke or fire alarms were set off
  • Fire extinguishers were used
  • The city or county fire department was called

Sample

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FIRE INCIDENT REPORT FORM
INDIVIDUAL FILING REPORT

Full Name: [FULL NAME] Title/Role: [TITLE/ROLE]
Signature:                                                           Date: [MM/DD/YYYY]

INCIDENT DETAILS
Date of Incident: [DATE OF INCIDENT]      Time: [TIME] ☐ AM ☐ PM

Location: [LOCATION]

Status of Fire Alarms: ☐ Working ☐ Not Working ☐ Not Present

Cause of Incident: [CAUSE OF INCIDENT]

Describe the Incident: [DESCRIBE THE INCIDENT]

PARTIES INVOLVED

  1. Full Name: [FULL NAME] Phone: [PHONE] E-Mail: [EMAIL] Address: [ADDRESS]
  2. Full Name: [FULL NAME] Phone: [PHONE] E-Mail: [EMAIL] Address: [ADDRESS]
  3. Full Name: [FULL NAME] Phone: [PHONE] E-Mail: [EMAIL] Address: [ADDRESS]
  4. Full Name: [FULL NAME] Phone: [PHONE] E-Mail: [EMAIL] Address: [ADDRESS]

INJURIES AND FATALITIES
Was anyone injured? ☐ Yes ☐ No    How many people were injured? [#]

If yes, describe the injuries: [INJURY DESCRIPTION]

Were there any fatalities? ☐ Yes ☐ No   How many? [#]

If yes, list their names: [FATALITIES]

PROPERTY DAMAGE

Was there any property or equipment damage? ☐ Yes ☐ No

If yes, describe the injuries: [PROPERTY DAMAGE DESCRIPTION]

FIRE DEPT./MEDICAL SERVICES
Fire Dept. Notified?☐ Yes ☐ No

If yes, at what time? [TIME] ☐ AM ☐ PM

Time of Arrival: [TIME] ☐ AM ☐ PM

Was medical treatment provided? ☐ Yes ☐ No ☐ Refused

If yes, where was medical treatment provided? ☐ On site ☐ Hospital ☐ Other: [OTHER]