Construction Site Injury Report
Project Name
Location
Date of Incident
Time of Incident
Injured Person's Name
Job Title
Contact Information
Supervisor on Duty
Witness(es)
Describe the Injury
Describe How the Incident Happened
Immediate Action Taken
Medical Attention Required?
Yes
No
Treatment Provided
Reported To (Name & Position)
Recommendations / Preventive Actions
Report Completed By
Date