Accident witness statement form

Accident witness statement form

 

Incident / accident is dark side of the organization, when organization product or supporting machinery, equipment are very heavy or the processes requirements are very critical for maintain the safe system that incident / accident prevent in organization. For minimize that incident / accident organization strongly recommend for the deep analysis on those data which collected from the accident / incident location.

Incident / accident investigation is primary requirements, collecting data and analysis on those incident / accident that result real root cause are identification is requirements to minimize the incident / accident in organization for provide safe working environment to workmen within company premises.

As dept of the incident / accident investigation, investigate team are go to accident place for the primary investigation & interact with witness for the understand what was really happen at time of the accident, when question and answer is very important for the investigations, accident investigation document are need to fill up for the records each movement of the interview with the people who was present at time of accident. Their statements are record in single form is accident witness statement form.

Some questions are ask to witness to understand situation, conditions, possibilities and real event demonstration that need to go in deep to find out the way , root of the real cause of the accident to elimination, some sample points are as below:

  1. Full Details of the accident
  2. details of work & condition in process
  3. unusual activities at time of accident found during observation
  4. what was the role of witness in whole process sequence
  5. what conditions prejudiced the accident
  6. opinion and suggestions

Accident witness statement form Page - I
Accident witness statement form Page – I

 

Accident witness statement form page 2
Accident witness statement form Page – II

 

For the detailed information, you can download form sample for accident witness statement form free:

EXAMPLES, SAMPLES & FORMATS

 

  1. ACCIDENT WITNESS STATEMENT FORM IN WORD DOCUMENT DOWNLOAD FREE
  2. ACCIDENT WITNESS STATEMENT FORM IN PDF FORMAT DOWNLOAD FREE
  3. ACCIDENT WITNESS STATEMENT FORM TEMPLATES DOWNLOAD
  4. ACCIDENT WITNESS STATEMENT FORM IN JPEG, PNG FORMAT DOWNLOAD

 

MOST IMPORTANT:

ACCIDENT WITNESS INTERVIEW GUIDELINE

 

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