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Violating employee's name
Reporting employee's name
Date / Time of incident
What violation has the employee committed?
Report prepared by

Do you run a business and need a way to report work related incidents and injuries? If so, you need an employee incident report form. With WPForms’ employee incident report form, you can streamline the process of documenting employee illnesses, injuries, and accidents so that you and your employees are fully protected.

With WPForms’ employee incident report form, you can collect the names of all involved parties, the date and time of the incident, the violation or accident that occurred, and a full description for you and your employees’ records.

We have created an employee incident report form demo below that you can use to easily get started without any technical knowledge.

What’s in the Employee Incident Report Form Demo

Launch this form as-is or customize it to your heart’s content!

With our simple Employee Incident Report Form Template you get the following form fields:

  • Name
  • Email
  • Date / Time
  • Multiple Choice
  • Paragraph Text

Of course, this is just an employee incident report form sample to get you started.

You can use our easy to use drag & drop form builder to add, remove, and customize the fields as needed.

For example, our employee incident report form template is designed to report employee incidents such as neglect of duty, poor performance, or violations of company policy. With WPForms’ smart conditional logic, you can configure the form to display multiple choice items related to the incident you’ve chosen from the Dropdown form field. Pick from Incident, Illness, or Accident, and show fields related to each only once selected.

In addition, you can add a File Upload form field to your employee incident report form so any pictures taken of the incident or accident can be documented for your records and insurance purposes. This is especially helpful for those injured while on the job. This can also be used to upload official doctor’s notes if someone becomes ill while working for you.

Lastly, set up multiple email notifications so that when a employee incident report form is submitted, everyone that needs a copy can receive one. For instance, you, your HR department, the insurance company, and any employees involved in the incident can receive an email outlining the entire report.

Do you want to officially sign any report submitted to prevent fake submissions aimed to get others in trouble? Add our Signature form field and sign your employee incident report forms.

So, what are you waiting for? Get started with WPForms today to create your own employee incident report form. Bonus, we’ll give you our employee incident report form template and over 100+ other pre-made form templates!