Real Estate Employee Incident Report Form

This form is to be completed promptly after any incident occurs. Please ensure all sections are filled out accurately and completely. Submit the completed form to the appropriate department for review and follow-up actions.

Date of Incident: [Date]

Time of Incident: [Time]

Employee Information

Employee Name:
Employee ID:
Department/Team:
Contact Number:
Email Address:

Incident Details

Location of Incident:
Description of Incident:
Witnesses:
Injuries Sustained:
Property Damage:

Actions Taken

• Immediate medical assistance provided

• Reported incident to supervisor/manager

• Secured the area to prevent further accidents

• Documented incident with photographs (if applicable)

• Notified relevant authorities (if necessary)

Follow-up Actions Required

Follow-up Investigation:
Corrective Actions:
Training Needed:
Additional Comments:

Employee Signature

[Employee Name]

[Date]

Manager Signature

[Manager Name]

[Date]

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