Laboratory Fume Hood Failure Incident Form
Date of Incident
Time of Incident
Laboratory Location/Room
Fume Hood ID/Number
Reported By
Contact Information
Description of Incident
Type of Failure
Mechanical Failure
Electrical Failure
Airflow Issue
Alarm Activation
Other
Immediate Actions Taken
Personnel Present
Any Injuries or Exposure?
No
Yes
Follow-Up Actions Needed
Additional Notes