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EHS Report 2.0

EHS Report Context

Complete the EHS Report for any incidents, near misses, or safety concerns/suggestions. Use the examples below to decide which category fits best and include as much detail as possible (who, what, where, when, how, and actions taken).

Near Miss

A close call that could have caused injury, damage, or harm but didn’t. It indicates a hazard that needs attention before it causes a real incident.

Incident

An unplanned event resulting in injury, illness, property damage, environmental impact, or any combination of these. Requires immediate reporting and investigation.

Safety Concern / Suggestion

Any identified hazard, unsafe condition, or idea for improvement that could prevent incidents or make the workplace safer.

Even if no personal injuries, environmental damage, or property damage occurred, it is everyone’s responsibility to report situations that could cause harm and, if possible, correct them.
What to include in your report
  • Who was involved or witnessed the event.
  • What happened (clear, factual description).
  • Where it occurred (location, site, or department).
  • When it happened (date and time).
  • How it happened (sequence of events and contributing factors).
  • Actions taken — immediate corrections, first aid, containment, or recommendations.
Select the type of report(Required)
General Details

Near Miss

Choose the Type of Near Miss(Required)
General Details

Near Miss General Details

MM slash DD slash YYYY
Time(Required)
:
General Details

Near Miss Information

General Details

Incident

Choose the Type of Incident

EHS Report Context
Description: Immediate care given on site for a minor injury that does not require professional medical treatment (example: small cut, minor burn, bandage).
EHS Report Context
Description: Treatment that requires a healthcare professional or outside medical facility (example: stitches, hospital visit, x-rays).
General Details

General Incident Details

Time of Incident(Required)
:
Time Employee Began Work
:
MM slash DD slash YYYY
General Details

Incident Specific Details

Was incident reported immediately?(Required)
Was the employee medevacked?(Required)
Type of Environmental Incident(Required)

What was affected?(Required)

How did it occur? List events chronologically
General Details

Witness Information

Were there witnesses to the incident?(Required)
General Details

First Aid Information

Was First Aid provided?(Required)
Treatment of Injury(Required)

Did you see a First Aid Attendant?(Required)
General Details

Medical Aid Information

Treatment of Injury(Required)

General Details

Environmental Information

Were external agencies notified?(Required)
General Details

Property Damage Information

Was any equipment damaged?(Required)
If yes, please also fill out a Property Damage Incident Report
Was medical or first aid treatment provided?(Required)
If yes, please also fill out a First Aid or Medical Aid Incident Report
General Details

Safety Concern / Suggestion Report

General Details

Attachments

Drop files here or
Accepted file types: jpg, png, Max. file size: 15 MB, Max. files: 5.

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