Use our readymade template to create this Google form. Customize it further using our form builder.
Build your accident investigation form with Google Forms
- Use our prebuilt template to create your accident investigation form
- Collect legally binding signatures from the investigator, supervisor, and EHS manager
- Capture investigator details such as Name, Email, and Job Title
- Record accident details such as Accident Date, Department, Location, and Victim Name
- Document the sequence of events, causes, and corrective actions
Collect digital signatures seamlessly
- Embed the form on your website or use the share link to collect responses
- Provide a user-friendly, secure and seamless signing experience
- Enable investigators, supervisors, and EHS managers to sign and submit the form from any device
- Send a confirmation email with the signed copy of the accident investigation form
- Allow users to save progress & complete the accident investigation form later
Track signed responses in Google Sheets and Drive
| A | B | C | D | E | |
|---|---|---|---|---|---|
| 1 | Investigator Name | Accident Date | What happened? | What caused the accident? | Signed PDF |
| 2 | John Doe | 2025-08-08 | The employee slipped on a wet floor while carrying heavy equipment. | The floor was wet due to a leaking pipe. The employee was not wearing slip-resistant shoes. | Signed PDF |
| 3 | Jane Smith | 2025-08-07 | A forklift tipped over while moving a heavy load. | The forklift was overloaded and the operator was not adequately trained. | Signed PDF |
| 4 | James Johnson | 2025-08-06 | An employee suffered a burn from a chemical spill. | The chemical container was not properly sealed and the employee was not wearing appropriate PPE. | Signed PDF |
| 5 | Emily Davis | 2025-08-05 | An employee fell from a ladder while performing maintenance work. | The ladder was not properly secured and the employee was not using a safety harness. | Signed PDF |
| 6 | Robert Brown | 2025-08-04 | A machine malfunctioned, injuring an operator. | The machine was not properly maintained and the operator did not follow safety procedures. | Signed PDF |
| 7 | Mary Williams | 2025-08-03 | An employee was struck by a falling object in the warehouse. | The object was not properly secured and the warehouse was poorly lit. | Signed PDF |
| 8 | William Jones | 2025-08-02 | An employee was exposed to harmful fumes in the lab. | The ventilation system was not working properly and the employee was not wearing a respirator. | Signed PDF |
| 9 | Patricia Miller | 2025-08-01 | An employee was injured while operating a power tool. | The power tool was defective and the employee was not trained to use it safely. | Signed PDF |
| 10 | Joseph Wilson | 2025-07-31 | An employee was injured in a vehicle accident on the company premises. | The vehicle was not maintained and the driver was not following traffic rules. | Signed PDF |
| 11 | Linda Moore | 2025-07-30 | An employee was injured during a fire drill. | The fire drill was not properly organized and the employee was not briefed on safety procedures. | Signed PDF |
- Sync the signed accident investigation form to your Google Drive for record keeping
- Easily track and manage your form responses using the Kanban board
- Automatically receive a copy of the signed accident investigation form by email
- Sync form responses with signatures to Google Sheets for further analysis
- Notify your team by email when an accident investigation form is submitted
These reviews are reproduced without modification from Google Workspace Marketplace.
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