Fall from Height Accident Report
Date of Incident
Time of Incident
Location
Approximate Height of Fall (meters)
Name of Injured Person
Job Title/Position
Department/Team
Description of Incident
Suspected Cause(s)
Nature of Injuries
First Aid/Treatment Provided
Witness(es) Name(s)
Reported To
Immediate Corrective Actions Taken
Further Actions Recommended
Report Prepared By
Date