The Incident Investigation Form is a critical document used in South African workplaces to ensure thorough and compliant investigation of workplace incidents, accidents, and near-misses. This document is mandated by the Occupational Health and Safety Act (OHSA) No. 85 of 1993 and must be completed whenever a reportable incident occurs in the workplace. The form captures essential information about the incident, including circumstances, involved parties, witness accounts, root cause analysis, and corrective actions. It serves multiple purposes: ensuring legal compliance, preventing future incidents, supporting worker compensation claims, and maintaining safety records. The structured format helps organizations maintain consistent investigation practices while meeting the requirements of South African health and safety regulations.
Thank you! Your submission has been received!
Oops! Something went wrong while submitting the form.
Your data doesn't train Genie's AI
You keep IP ownership of your docs
1. Incident Reference Information: Basic identifying information including incident number, date/time of incident, date/time reported, and location
2. Type of Incident: Classification of incident (injury, near-miss, property damage, environmental, etc.) and severity rating
3. Affected Persons: Details of all persons involved, injured or affected by the incident, including employees, contractors, or members of the public
4. Incident Description: Detailed narrative of what happened, including sequence of events and immediate actions taken
5. Environmental Conditions: Weather, lighting, workplace conditions, and other environmental factors at time of incident
6. Equipment Involved: Details of any machinery, tools, or equipment involved in the incident
7. Witness Information: Names and contact details of witnesses, with reference to their statements
8. Root Cause Analysis: Investigation findings identifying direct and underlying causes of the incident
9. Immediate and Underlying Causes: Analysis of factors that contributed to the incident
10. Corrective Actions: Specific actions required to prevent recurrence, including responsible persons and timelines
11. Investigation Team: Names and roles of persons conducting the investigation
12. Sign-off Section: Signatures of investigation team, safety representative, and management
1. Medical Report Section: Required when incident involves injury - details of medical treatment, first aid provided, and medical professional's assessment
2. Environmental Impact Assessment: Required for incidents involving environmental damage or potential environmental risks
3. Cost Impact Analysis: Optional section for calculating direct and indirect costs of the incident
4. Legal Compliance Review: Required when incident involves potential regulatory breaches
5. Union Representative Input: Required when incident involves unionized employees or workplace representation is necessary
6. Risk Assessment Review: Required when incident reveals new or previously unidentified risks
7. Training Record Review: Required when incident may be related to training inadequacies
1. Appendix A - Witness Statements: Detailed statements from all witnesses, signed and dated
2. Appendix B - Photographic Evidence: Photos of incident scene, damage, or relevant equipment with descriptions
3. Appendix C - Sketches and Diagrams: Drawings showing incident scene layout and relevant details
4. Appendix D - Supporting Documentation: Relevant procedures, risk assessments, maintenance records, training records
5. Appendix E - Medical Reports: Copies of medical assessments, treatment records (if applicable)
6. Appendix F - Equipment Reports: Technical reports, maintenance records, or inspection certificates for involved equipment
7. Appendix G - Incident Timeline: Detailed chronological sequence of events before, during, and after the incident
Find the exact document you need
Security Guard Report Form
A PSIRA-compliant security incident reporting form for security guards in South Africa, enabling systematic documentation of security-related events and responses.
Download
Patient Safety Incident Reporting Form
A South African-compliant Patient Safety Incident Reporting Form for documenting and tracking healthcare safety incidents while maintaining patient privacy and regulatory compliance.
Download
Incident Notification Form
A mandatory South African workplace incident reporting form required under OHSA legislation for documenting accidents, injuries, and dangerous occurrences in the workplace.
Download
Health And Safety Incident Report Form
A standardized form for recording workplace health and safety incidents in compliance with South African OHSA requirements.
Download
Hazard Incident Report Form
A standardized South African workplace hazard and incident reporting form compliant with OHS Act requirements for documenting and reporting workplace safety incidents.
Download
Work Place Injury Report Form
A South African legal document for reporting workplace injuries in compliance with OHSA and COIDA requirements.
Download
Critical Incident Report Form
A standardized form for documenting critical incidents in South African workplaces, ensuring compliance with local health and safety regulations while facilitating incident investigation and prevention.
Download
Security Incident Report Form
South African-compliant Security Incident Report Form for documenting and reporting security breaches under POPIA and relevant local regulations.
Download
Incident Response Form
A structured form for documenting and managing security incidents in compliance with South African regulations, including POPIA and the Cybercrimes Act.
Download
Incident Investigation Form
A South African workplace incident investigation documentation tool compliant with OHSA requirements, used to record, analyze, and respond to workplace incidents and accidents.
Download
ұԾ’s Security Promise
Genie is the safest place to draft. Here’s how we prioritise your privacy and security.
Your documents are private:
We do not train on your data; ұԾ’s AI improves independently
All data stored on Genie is private to your organisation
Your documents are protected:
Your documents are protected by ultra-secure 256-bit encryption
We are ISO27001 certified, so your data is secure
Organizational security:
You retain IP ownership of your documents and their information
You have full control over your data and who gets to see it
.png)