Hazard Incident Report Form Template for Philippines

1. Medical Response Details: To be included when the incident resulted in injury or illness requiring medical attention

2. Environmental Impact: For incidents involving environmental releases or potential environmental damage

3. Equipment/Property Damage: Details of any damage to equipment, facilities, or property when applicable

4. Chemical/Hazardous Material Details: Specific section for incidents involving hazardous substances, including SDS references

5. Third Party Involvement: Information about any third parties involved in or affected by the incident

6. Production Impact Assessment: Details of how the incident affected operations and production, if applicable

7. Initial Root Cause Analysis: Preliminary assessment of factors contributing to the incident, if immediately apparent

1. Incident Scene Photographs: Photos documenting the incident scene, damage, or hazardous conditions

2. Sketch/Layout: Diagrams or sketches showing the incident location and relevant details

3. Witness Statements: Detailed written accounts from witnesses

4. Medical Reports: Copies of initial medical reports or first aid records if applicable

5. PPE Checklist: Documentation of personal protective equipment in use at the time of incident

6. Risk Assessment Form: Pre-existing risk assessment for the task/area where the incident occurred

7. Incident Classification Guide: Reference guide for categorizing the severity and type of incident