We use analytics only if you accept. Details in Cookies and privacy.

Sign in

Safety incident report form

Record an incident, who was involved, and the follow-up steps.

Saved on this device only.

The date of the incident.

Where it happened.

A short description in your own words.

Who was there. Do not type a social insurance number.

Injury (required)

What you observed. This does not classify a claim.

Follow-up

  • Step 1

    One thing still to do or already done.

    Tick this when the step is finished.

Result

Safety incident report form

Injury (required)
None noticed
Step 1 Done
No

Follow-up done

—

Describe the incident and add a follow-up step.

Estimate for planning only. This is not tax, legal, accounting or financial advice. Results depend on the figures you enter. Check all numbers, rates and rules with the official source or a qualified professional before relying on them.

How this works and common questions

About this tool

This form keeps a note of what you type: the date, the place, what happened, who was involved, and follow-up steps. It is not a report to a board or an insurer. A starting point, not legal advice. Saved on this device only.

How it works

Two follow-up steps, with one ticked, show 1 of 2. The date, place, description, and names you type are listed on the printout and in the CSV. Nothing is rounded.

Rules

You write what happened and who was involved. Each follow-up row is one step, ticked or not. The result is the count of ticks. This form is not a legal record, not a workers' compensation filing, and not proof that a duty was met. A starting point, not legal advice. Saved on this device only.

Questions

Is this a legal record or a claim form?

No. It is a starting point, not legal advice, and not a filing with a compensation board or an insurer.

Where is the report kept?

Saved on this device only. It is not sent to an account or to analytics. Clear from this device removes it.

What does the result count?

It counts follow-up steps you marked done. One tick out of two steps shows 1 of 2. Nothing is rounded.

Do I need an account?

No. The tools work without one. You only need to sign in to save your work.

Is what I type saved?

Saved on this device only. What you type is not sent to an account or to analytics. Clear from this device removes it.

Do you show ads or sell my information?

No. We show no ads and we do not sell your information.

Is this tax or legal advice?

No. Results are estimates for planning. Check rates and rules with the official source or a qualified professional.

Saved on this device only. What you type is not sent to an account or to analytics. Clear from this device removes it.

Estimate for planning only. This is not tax, legal, accounting or financial advice. Results depend on the figures you enter. Check all numbers, rates and rules with the official source or a qualified professional before relying on them.