Incident report form
Write up an incident while the detail is still fresh
The same incident report RISE ships with, filled in here. It asks the questions an investigation needs answered later, and prints as a finished report you can file or hand on.
What you get from the form
The right questionsSeven incident types, severity, contributing factors and recommendations.
Detail while it lastsThe questions that are easy to answer today and impossible to reconstruct in a month.
Something to doWhat a team does after an incident is written up, which is the part a blank form never tells you.
A finished reportPrint it or save it as a PDF, and hand it to whoever picks up the investigation.
How it rates
What the severity level means
One field carries the rating: how bad the outcome actually was, on the five level scale RISE uses everywhere it records severity.
Level 1
Negligible
15
Level 2
Minor
15
Level 3
Moderate
15
Level 4
Major
15
Level 5
Catastrophic
15
One level, and no score to go with it.
A hazard is severity times probability, because it has not happened yet. An incident has, so probability is not a question and there is no matrix to plot. The level is recorded the way the product records it, and what happens next is driven by the investigation rather than by a number.
Your turn
Let’s get started
Fill it in for something that has already happened. It records what an investigation will need later, and hands back a finished report.
Report details
A short name for what happened, the way you would say it out loud.
Include a detailed and accurate description while being as concise as possible.
5 answers still needed.
Discover how RISE can empower your safety program
A guided walkthrough of how RISE handles reporting, evaluation, resolution and insight, with time to talk about how your own operation runs today.
