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Work Place Injury Report Form

Work Place Injury Report Form Template for Singapore

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Key Requirements PROMPT example:

Work Place Injury Report Form

"I need a Workplace Injury Report Form for our Singapore manufacturing facility to document a machinery-related incident that occurred on January 15, 2025, involving three workers and requiring immediate medical attention."

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The Workplace Injury Report Form is a crucial document required under Singapore's workplace safety legislation. It must be completed when an employee sustains an injury during work or develops an occupational disease. The form captures essential details about the incident, including the nature of injury, circumstances, witness accounts, and medical treatment provided. This documentation is vital for regulatory compliance, insurance claims, and workplace safety improvements. Companies must submit this report to MOM within 10 days of the incident for reportable cases, as specified under the WSHA and WICA frameworks.
Suggested Sections

1. Incident Information: Basic details including date, time, and location of the workplace incident

2. Employee Details: Personal information of injured worker including name, ID, contact details, job title, and employment status

3. Injury Description: Detailed description of the injury including type, severity, and affected body parts

4. Incident Description: Comprehensive account of how the incident occurred, including activities being performed and immediate causes

5. Witness Information: Contact details and role of any witnesses present during the incident

Optional Sections

1. Medical Treatment Details: Information about immediate medical attention provided, including first aid and hospital treatment

2. Equipment/Machinery Involved: Details of any equipment or machinery involved in the incident, including maintenance records

3. Third Party Details: Information about any external parties involved in or affected by the incident

Suggested Schedules

1. Medical Reports: Attached medical documentation, diagnoses, and treatment plans

2. Photographic Evidence: Photographs of the incident scene, injuries, or equipment involved

3. Witness Statements: Written testimonies from witnesses who observed the incident

4. Risk Assessment Forms: Copies of relevant workplace risk assessments and safety procedures

Authors

Alex Denne

Head of Growth (Open Source Law) @ Genie AI | 3 x UCL-Certified in Contract Law & Drafting | 4+ Years Managing 1M+ Legal Documents | Serial Founder & Legal AI Author

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alex.den.21@genieai.co
Industries

WSHA: Workplace Safety and Health Act - Primary legislation governing workplace safety and incident reporting requirements in Singapore

WICA: Work Injury Compensation Act - Primary legislation governing compensation for workplace injuries in Singapore

PDPA: Personal Data Protection Act - Legislation governing the collection, use, and disclosure of personal data in Singapore

Incident_Reporting_Regulations: Workplace Safety and Health (Incident Reporting) Regulations - Specific regulations detailing reporting requirements for workplace incidents

WIC_Regulations: Work Injury Compensation Regulations - Detailed regulations on compensation procedures and requirements

WSH_General_Provisions: Workplace Safety and Health (General Provisions) Regulations - General safety and health requirements in workplaces

Fatal_Accident_Reporting: Requirement to report fatal accidents to MOM within 10 days of occurrence

Non_Fatal_Accident_Reporting: Requirement to report non-fatal accidents to MOM within 10 days of occurrence

Dangerous_Occurrence_Reporting: Requirement to report dangerous occurrences to MOM within 10 days of occurrence

Occupational_Disease_Reporting: Requirement to report occupational diseases to MOM within 10 days of diagnosis

Teams

Employer, Employee, Start Date, Job Title, Department, Location, Probationary Period, Notice Period, Salary, Overtime, Vacation Pay, Statutory Holidays, Benefits, Bonus, Expenses, Working Hours, Rest Breaks,  Leaves of Absence, Confidentiality, Intellectual Property, Non-Solicitation, Non-Competition, Code of Conduct, Termination,  Severance Pay, Governing Law, Entire Agreemen

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