Incident Report

Person, Place, Time




mm/dd/yyyy 11:22 AM

Individual's Initials and Three Digits -20Y

Include code, dash, and anything after the dash.



The form will error out if the project code is wrong!




If during a training in the field, select "work" from the options provided. If training in office or other indoor facility, type "training"

What is the work the crew is performing, the work of the project? Not necessarily what the individual was doing at the time of the incident: "Preparing Dinner" or Maintaining a saw" is not the type of work the crew is doing.


What happened? If this was a close call, what almost happened?


Select which Staff will receive and review your submission






Incident Information




Overuse = asking too much, load-wise, of a muscle group; Repetetive Motion = using that muscle group too frequently

The definition of each Incident Level can be found here.

Optional




Describe the incident, materials/people involved, conditions/terrain, etc. AVOID USING THE NAME OF THE PERSON INVOLVED IN THE INCIDENT.  ie. (FCL was injured rather than Greg Ross was injured. Names of others who helped, etc are fine, 

Less is more. If an irritant got into someone's eye, don't check "head" as well, even though eyes are generally located in the head

In what ways might someone else have acted/reacted differently? What are some personal or crew dynamics that may have influenced the situation?

Chainsaw & Vehicle Specific





Use Ctrl to select more than one option

Use Ctrl to select more than one option

Use Ctrl to select more than one option

Property Damage



Close Calls


Describe the incident, materials/people involved, conditions/terrain, etc. AVOID USING THE NAME OF THE PERSON INVOLVED IN THE INCIDENT. ie. (FCL was injured rather than 'Greg Ross was injured...' Names of others who helped, etc are fine,

Photos and Supporting Documents

PLEASE READ: Uploading files to Salesforce is possible but not mandatory. Salesforce does not have ton of storage so please limit supporting documents to those that are particularly relevant. Ie. Has the potential to be used in future training, documentation of property damage for insurance reasons, unique teachable moments, etc.