# Incident Report Template, Free to Fill Source: https://nerix.ai/templates/incident-report Record an accident, near miss or other incident clearly: facts first, then causes and actions. Before you send it Serious injuries, deaths, dangerous events and some data breaches must be reported to an authority within a set time in many countries. Do that first if the law requires it, and keep this report to facts, not blame. Handle injured people's personal and health information with care. ## Fill it in and preview You are signed in. Fill it in your workspace and it is kept as a document you can send, share and have signed. [Open in your workspace](https://app.nerix.ai/documents/templates/incident-report) ### Incident report **Company or site:** Brightwater Bakery, Cork **Report number:** INC-2026-017 **Type of incident:** Type of incident **Date and time:** 2 December 2026 , 14:35 **Where:** Production area, next to oven 2 **Reported by:** Sean Murphy, shift lead ## 1. People involved Aoife Byrne (baker), injured person **Witnesses:** Liam Walsh, Niamh Kelly ## 2. What happened At about 14:35 Aoife slipped on spilled flour while carrying a tray to oven 2 and fell onto her right wrist. She was able to stand up and was taken to the first aid room. **Injuries or damage:** Swollen right wrist. Taken to hospital by taxi at 15:10 for an X-ray. ## 3. Immediate actions First aid given by Sean Murphy. Floor cleaned and the area closed off. Aoife taken to hospital. ## 4. Causes and prevention **Likely causes:** Flour on the floor next to the mixer had not been cleaned up, and the cleaning rota did not cover this area in the afternoon. **Actions to prevent it happening again:** Add an afternoon floor check to the rota (Production manager, by 10 December). Buy a second floor scraper (Sean Murphy, by 7 December). **Reported to an authority:** Not required for this injury ## 5. Sign off I confirm that the facts above are correct to the best of my knowledge. Reporter's signature: ______________ Date: ______________ Reviewed by (name and role): ______________ Signature: ______________ Date: ______________ Templates are a careful starting point, not legal advice. Where the law matters, check what applies where you are. Operations and quality ## What this template is for An incident report for workplace accidents, near misses and security events: what happened, who was involved, injuries, immediate actions and follow-up. It is free to fill in online, needs no account, and downloads as a Word document or a PDF. [See all Operations and quality templates](https://nerix.ai/templates/operations-quality) Operations and quality ## What you fill in The form asks for 15 details. The document fills itself in as you type. - ### Company or site For example: Brightwater Bakery, Cork - ### Report number (optional) optional For example: INC-2026-017 - ### Type of incident - ### Date of the incident For example: 2 December 2026 - ### Time For example: 14:35 - ### Where it happened For example: Production area, next to oven 2 - ### Reported by For example: Sean Murphy, shift lead - ### People involved Names and roles. Add only what is needed. For example: Aoife Byrne (baker), injured person - ### Witnesses (optional) optional For example: Liam Walsh, Niamh Kelly - ### What happened Facts in the order they happened. Say what you saw, not what you think. For example: At about 14:35 Aoife slipped on spilled flour while carrying a tray to oven 2 and fell onto her right wrist. She was able to stand up and was taken to the first aid room. - ### Injuries or damage (optional) optional For example: Swollen right wrist. Taken to hospital by taxi at 15:10 for an X-ray. - ### Immediate actions taken For example: First aid given by Sean Murphy. Floor cleaned and the area closed off. Aoife taken to hospital. - ### Likely causes (optional) optional For example: Flour on the floor next to the mixer had not been cleaned up, and the cleaning rota did not cover this area in the afternoon. - ### Actions to prevent it happening again For each action, say who and by when. For example: Add an afternoon floor check to the rota (Production manager, by 10 December). Buy a second floor scraper (Sean Murphy, by 7 December). - ### Reported to an authority (optional) optional If you reported it, say to whom, when and the reference. For example: Not required for this injury Operations and quality ## What is inside The parts of this document, in order. - 1 1. People involved - 2 2. What happened - 3 3. Immediate actions - 4 4. Causes and prevention - 5 5. Sign off Templates ## How it works - 01 ### Fill in Type your details in the form. The document fills itself in as you type; click any gap to jump to its field. - 02 ### Check Read it through. Gaps you have not filled stay marked, so nothing goes out half done. - 03 ### Download Save it as a Word document to edit further, or as a PDF to send or print. ### Make it yours with AI Open it in the chat and ask for changes: shorter, firmer, another situation, another language. [Adapt it with nerix](https://nerix.ai/try?template=incident-report) ### Was this template helpful? Operations and quality ## Questions people ask ### What details does this template ask for? The form asks for 15 details, starting with Company or site, Type of incident, Date of the incident, Time, Where it happened. 5 more are optional. ### Can I download this template as Word or PDF? Yes. When you have filled in the form, save it as a Word document to keep editing, or as a PDF to send or print. It is free and needs no account. ### Is what I type sent anywhere? No. What you type stays in your browser while you fill in the document. It only goes to nerix if you choose to open the template in the chat. ### What should I check before I use this template? Serious injuries, deaths, dangerous events and some data breaches must be reported to an authority within a set time in many countries. Do that first if the law requires it, and keep this report to facts, not blame. Handle injured people's personal and health information with care. ### Are these operations templates free? Most are. Fill in and download them for free as Word or PDF, with no account. A few longer documents are premium: free to fill in, paid once to download, and marked with their price. ### Do they meet a standard such as ISO 9001? They are a practical starting point and certify nothing. Standards and safety laws differ by industry and country, so check what applies to you. ### Who should approve a procedure? The person who owns the process and a manager who can authorise it. The procedure template has fields for both, and for the review date. Templates ## More in Operations and quality - [Allergen and food safety record One page for the kitchen: allergens by dish, daily temperature and cleaning checks, and what was done about problems. Operations and quality](https://nerix.ai/templates/allergen-and-food-safety-record) - [Asset handover and return form Record equipment given to a person and returned later, with condition and signatures. Operations and quality](https://nerix.ai/templates/asset-handover-and-return-form) - [Asset register List what the business owns: each asset, who has it, where it is, what it is worth and its condition. Operations and quality](https://nerix.ai/templates/asset-register) - [Business continuity plan Plan how to keep critical work going through a fire, outage, supplier failure or loss of people. Operations and quality Premium, €4.99](https://nerix.ai/templates/business-continuity-plan) - [Capacity plan Work out whether you can meet future demand: current use, expected growth, gaps, options and what to decide. Operations and quality](https://nerix.ai/templates/capacity-plan) - [Class register Record attendance for one class or session, with late and absent names and the reason. Operations and quality](https://nerix.ai/templates/class-register) [See all Operations and quality templates](https://nerix.ai/templates/operations-quality) Templates ## More kinds of documents Every category has its own page, so you can see all of its templates at once. ## Use it in nerix ### Use it in nerix - [Templates](https://nerix.ai/product/templates) - [Quality records](https://nerix.ai/product/quality-records) - [Checks](https://nerix.ai/product/audits) ### Learn more - [How to Make a Document From a Template](https://nerix.ai/help/make-a-document-from-a-template) - [Operations and quality](https://nerix.ai/templates/operations-quality) ## Keep reading - Quality and audits incidents [Quality and audits](https://nerix.ai/blog/category/quality-and-audits) October 31, 2026 5 min read ### [Incident report template and how to investigate](https://nerix.ai/blog/incident-report-template-and-how-to-investigate) How to write an incident report and investigate it: what to record in the first hour, how to find the cause, what to fix and when to tell an authority. Read the guide