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  • The injured person(s)'s  name(s)
  • Their contact information (address, phone number, extension)
  • Their department
  • Their work ID number
  • The time and date of the incident
  • The events leading to the incident
  • Any contributing factors to the incident
  • The details of the illness or injuries sustained
  • The treatment of the injuries or illness
  • Any time off due to the incident

Be as specific as possible when writing a Workplace Injury Report Form, since you'll use this form to complete the OSHA Form 301 (Injury and Illness Report). The Workplace Injury Report Form is the primary record of the event, so include as many details as you can, make copies, and file them. That way, you can review the form if there is ever a lawsuit or dispute about the event (accident or illness).

Complete a Workplace Injury Report Form today with Rocket Lawyer's easy online interview. You can also Find a Business Lawyer or Personal Injury Lawyer.

This article contains general legal information and does not contain legal advice. Rocket Lawyer is not a law firm or a substitute for an attorney or law firm. The law is complex and changes often. For legal advice, please ask a lawyer.


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