Construction Incident Report Template

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Construction Incident Report Template

A construction incident report is completed when a work-related accident, injury, or offense happens on the job site. The document records the people involved, the place and time of the incident, a detailed description of what happened, the names of any witnesses, and whether police or emergency services were contacted.

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Last updated August 21st, 2025

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A construction incident report is completed when a work-related accident, injury, or offense happens on the job site. The document records the people involved, the place and time of the incident, a detailed description of what happened, the names of any witnesses, and whether police or emergency services were contacted.

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When to Use

  • Workplace accidents and injuries
  • Equipment malfunction or breakdown
  • Medical emergencies
  • Damaged or stolen property
  • Illegal activity (drug use/possession, illicit weapons, etc.)
  • Broken protocol

Internal Reporting vs. OHSA Reporting

Internal Reporting

  • For all types of construction incidents
  • Maintains an in-house record of all incidents
  • May be required as a reference for insurance and other claims
VS

OSHA Reporting

  • For serious injuries and hospitalizations only
  • Required for companies with 10 or more employees
  • Uses a mandated form

Sample

Download: PDF, MS Word, ODT

CONSTRUCTION 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]

Describe the Incident: [DESCRIBE THE INCIDENT]

PARTIES INVOLVED
Full Name: [FULL NAME] Phone: [PHONE] E-Mail: [EMAIL] Address: [ADDRESS]
Identification: ☐ Driver’s License No. [DL NUMBER] ☐ Passport No. [PASSPORT NUMBER] ☐ Other: [OTHER]

Full Name: [FULL NAME] Phone: [PHONE] E-Mail: [EMAIL] Address: [ADDRESS]
Identification: ☐ Driver’s License No. [DL NUMBER] ☐ Passport No. [PASSPORT NUMBER] ☐ Other: [OTHER]

INJURIES
Was anyone injured? ☐ Yes ☐ No If yes, describe the injuries: [INJURY DESCRIPTION]

PROPERTY DAMAGE

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

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

WITNESSES
Were there witnesses to the incident? ☐ Yes ☐ No

If yes, enter the witnesses’ names and contact info:

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

POLICE/MEDICAL SERVICES
Police Notified?☐ Yes ☐ No

If yes, was a report filed? ☐ Yes ☐ No

Was medical treatment provided? ☐ Yes ☐ No ☐ Refused

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