Civil Engineering Construction Site Accident Report
Basic Information
Project Name
Location
Date of Accident
Time of Accident
Personnel Involved
Name of Injured Person
Role/Position
Supervisor in Charge
Witness(es)
Accident Details
Nature of Accident
Fall
Slip
Struck By Object
Caught-In/Between
Electrical Incident
Equipment Incident
Other
Description of Accident
Description of Injury/Damage
Immediate Actions Taken
Medical Treatment Provided
Investigation
Probable Cause(s) of Accident
Preventive/Corrective Actions
Report Completion
Reported By
Date
Signature