Workplace Incident Response Audit Form
Audit and assess the effectiveness of workplace incident response procedures. Please complete each section based on your review of the incident handling process.
Type of Incident Reviewed
*
Please Select
Injury/Accident
Near Miss
Property Damage
Security Breach
Other
How promptly was the incident reported?
*
Immediately
Within 1 hour
Within same shift
After more than one shift
Initial response actions were appropriate and timely.
*
Strongly Disagree
1
2
3
4
Strongly Agree
5
1 is Strongly Disagree, 5 is Strongly Agree
Effectiveness of communication during incident response
*
1
2
3
4
5
Incident documentation completeness
*
Comprehensive
Adequate
Partial
Insufficient
Escalation process followed as per protocol
*
Never
1
2
3
4
Always
5
1 is Never, 5 is Always
Corrective actions taken addressed root causes
*
Strongly Disagree
1
2
3
4
Strongly Agree
5
1 is Strongly Disagree, 5 is Strongly Agree
Follow-up actions were completed within required timeframes
*
Yes, all on time
Some delayed
None completed
Overall effectiveness of the incident response
*
1
2
3
4
5
Additional auditor comments or recommendations
Submit Audit
Should be Empty: