Laboratory Fire Incident Documentation Form
Incident Details
Date of Incident
Time of Incident
Laboratory Location
Room Number
Reporting Personnel
Name
Position/Title
Contact Information
Incident Description
Describe the incident
Chemicals/Equipment Involved
Cause of Fire (if known)
Immediate Actions Taken
Persons Involved
Names of Persons Involved/Injured
Nature of Injuries (if any)
Response and Follow-up
Emergency Services Contacted
Yes
No
Names of Emergency Responders
Further Actions/Recommendations