Accident / Incident Record Template (UK, A4 Fillable PDF) – Docuqo 0100

Accurately record workplace accidents, incidents, and near misses with this professional Accident / Incident Record Template (Docuqo 0100) — a clean, A4 fillable PDF designed for UK employers, contractors, and small businesses.

This form provides a clear, structured way to document what happened, who was involved, and any injuries sustained. It supports good record-keeping, internal investigations, and compliance with UK health & safety expectations, including RIDDOR reporting where applicable.

Designed for everyday workplace use, this template is suitable for offices, warehouses, construction sites, workshops, schools, and small industrial environments.

✔ UK-focused layout aligned with HSE expectations
✔ Fillable on screen or printable for manual completion
✔ Ideal for accident books, site files & H&S systems
✔ Includes RIDDOR section for employer use

What This Accident / Incident Record Is Used For

This form is used to record:

• Workplace accidents
• Incidents (with or without injury)
• Near misses

It does not replace a Risk Assessment, Method Statement, RAMS, or statutory reporting requirements — but supports them by providing clear, consistent documentation.

What’s Included

This professional Accident / Incident Record includes the following sections:

General Information

• Name of place
• Address
• Person or office responsible for storing accident records
• Consecutive report number

1. About the Person Who Had the Accident / Incident

• Name
• Address
• Postcode
• Occupation

2. About You (Person Completing the Record)

• Name
• Address
• Postcode
• Occupation

(For use when the injured person is not completing the form themselves.)

3. Details of the Accident / Incident

• Date and time of incident
• Exact location
• Description of how the incident happened
• Cause (if known)
• Injury details (if applicable)

Includes a clear note advising when to attach continuation sheets if more space is required.

4. Sign and Date

• Confirmation that details are recorded accurately
• Signatures and printed names for:
  • Injured person
  • Person completing the record

5. Employer Use Only – RIDDOR (If Applicable)

• Is the incident reportable under RIDDOR?
• Method of reporting (HSE Online / Telephone)
• RIDDOR reference number
• Reporter name, signature, and date

Customisable & Easy to Use

• Fill in digitally using Adobe Acrobat Reader (FREE)
• Print for handwritten completion if preferred
• Clean layout designed for clarity, legibility, and audit trails
• Suitable for inclusion in wider Docuqo H&S Systems

Perfect For

• Small UK businesses
• Construction & trade contractors
• Warehouses & logistics
• Offices & commercial premises
• Facilities & maintenance teams
• Schools, workshops & light industrial sites

Use as part of your accident book, site safety records, or internal H&S documentation system.

Why Choose Docuqo Templates?

• Designed in the UK with 25+ years of professional form & print experience
• Clear, practical layouts — no unnecessary jargon
• No subscription or specialist software required
• Lifetime use — download once, reuse forever
• Built specifically for UK SMEs

File Formats Included

• Fillable A4 PDF (type, save & email)
• Standard A4 PDF (print & write)
• Example completed record included

Docuqo Code: 0100

Legal & Licensing

© Docuqo.com
For personal or business use within one organisation.
Resale, redistribution, or sharing outside your organisation is prohibited.

Digital download only — no physical item shipped.
All sales are final due to the digital nature of this product.
Support is available if you need help accessing your files.