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?

Actions Taken

Follow-up and Prevention

Immediate corrective actions Recommended steps to prevent future accidents

Supervisor Review

Supervisor Name

Date

Supervisor Comments