First Response Incident Report TEMPLATE Page 01 01 FIRST RESPONSE INCIDENT REPORT Use this First Response Incident Report template to record any incident immediately after it occurs at your workplace. These reports are widely usable in cases related to health & safety management, security, emergency response, andincident investigation. Reporting Guideline: Document the facts of the incident as soon as it occurs The first person or team responding to the incident should prepare this report Provide an accurate record for follow-up investigations Support the corrective actions and preventive strategies Ensure compliance with internal and regulatory reporting requirements 01 01 INFORMATION ON CONDUCTING THE REPORT 1. Date of the incident: 2. Time of the incident: 3. Location of the incident: 4. Site/Project Name: Date of Preparing the Report: Time of Preparing the Report: Location: Prepared by: FIRST INCIDENT 5. Incident priority (Select one): Urgent High Medium Low Trivial 02 6. Incident type (Select Multiple): Hazard Near Miss Slip & Fall Accident Injury Theft Fire Property Damage Chemical Spill Fatality Illness Other 7. Was immediate medical attention administered? (Select one): Yes No 8. What kind of medical attention was administered? First Aid Doctor Consultation Hospital Ambulence Medical Attention was Declined 03