Construction Accident Report Form
Your Full Name
Name
Surname
Accident Date and Time
 /
Gün
 /
Ay
Yıl
2 digit day, 2 digit month, 4 digit year
You can enter an estimated time if you are not sure about the exact time.
1
Who was/were Involved in the Accident?
If there are more than one person, type the names by separating with comma. (Name Surname, Name Surname)
Describe the Accident Shortly
If there was no possibility for an injury, leave this place empty.
Was There Any Injuries in the Accident?
Choose One
Yes
No
Who was Injured?
If there are more than one person, type the names by separating with comma. (Name Surname, Name Surname)
What Kind of Injuries Could There be?
If there was no possibility for an injury, leave this place empty.
What could be done to avoid the accident?
Submit
Should be Empty: