Register of Injuries Form

The Register of Injuries Form is a critical document designed to record and track workplace injuries and illnesses in compliance with workplace health and safety regulations. This form captures detailed information about the incident, including the nature and location of the injury, circumstances of the event, and any equipment involved. It also includes sections for witness information, follow-up actions, and management’s investigation and response. By maintaining accurate records with this form, businesses can ensure they meet legal obligations, improve workplace safety, and support injured workers effectively.

What’s Included:

1. Injured Worker’s Details:
   • Fields for the worker’s family name, first name, position, department, and manager or supervisor’s name.
2. Injury/Illness Details:
   • Sections to record the date, time, nature, and bodily location of the injury or illness.
   • Space to describe how the injury occurred and whether any equipment was involved.
3. Witness Information:
   • Fields to list any witnesses to the injury or illness, including their full names and contact numbers.
4. Follow-Up Actions:
   • Questions to confirm if the injury was reported to the supervisor and whether any treatment was provided, with space for details.
5. Details of Person Making the Entry:
   • Sections for the name, position, department, and signature of the person documenting the incident, including the date of the entry.
6. Manager/Supervisor’s Investigation:
   • Questions to confirm whether an investigation was conducted and details of any controls implemented to prevent recurrence.
7. Employer Confirmation:
   • Space for the employer’s name, signature, and the date to confirm receipt of the injury notification.