Warehouse Loading Dock Accident Report
General Information
Date
Time
Location of Incident
Reported By
Contact Information
People Involved
Name(s)
Role/Job Title
Employee ID
Accident Details
Describe what happened
Equipment or Vehicles Involved
Witnesses (Names and Contacts)
Injury / Damage
Describe any injuries or damages
Was medical attention required?
Yes
No
Actions Taken
Follow-up and Prevention
Immediate corrective actions
Recommended steps to prevent future accidents
Supervisor Review
Supervisor Name
Date
Supervisor Comments