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Accident report form. A printable accident, incident and near miss report form — what happened, who was involved, what was done, and whether it needs reporting under RIDDOR.

This is the paper version. BuildOptix does the same job on a phone, with the record filed against the site and the operative automatically.

First page of the Accident report form PDF
3 pages · A4 · PDF

What is on the sheet

  • The injured person or the people involved, their employer and their role on site
  • When and where it happened, and what they were doing at the time
  • What happened, in the words of the person reporting it, and the injury or damage
  • Immediate action taken: first aid, medical treatment, the scene, the plant or equipment involved
  • Witnesses, and whether statements were taken
  • A RIDDOR consideration block — who decided, when, and the outcome — plus investigation, root cause and actions with owners

Why this record matters

The first job of an accident form is to capture what happened while somebody still remembers it. That is why the narrative is a writing area in the reporter's own words rather than a set of categories — categories are for analysing accidents later, and they lose exactly the detail an investigation needs.

Near misses are on the same form on purpose. A site that reports only injuries is a site that learns only from the ones where somebody was unlucky, and near misses are the same events with better outcomes. A separate near miss form almost always means near misses stop being reported.

The RIDDOR block asks who decided and when, rather than telling you what is reportable. What must be reported, by whom and in what time differs by the kind of event and has changed; printing a deadline on a free form is how somebody reports late because of us. The form prompts the question and names the person who answered it.

Root cause is separated from immediate cause because the immediate cause is almost never the useful one. 'Operative slipped' is where most investigations stop; why there was standing water, why nobody reported it, and why the same thing happened in March is where the next accident gets prevented.

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© 2026 BuildOptix. Free to print, copy and use in your business. Not for resale. Please keep this notice.

Contains public sector information licensed under the Open Government Licence v3.0. General guidance, not legal advice. Checked October 2026.