Incident report form
An incident report is only useful if it is filed close to the moment, in a shape that sorts. Splitting the timestamp into a date field and a time field, and severity into a fixed scale rather than a paragraph, is what turns a folder of descriptions into a list you can triage. This form does not investigate anything on its own — it collects what happened, when, and how serious it looked to the person who saw it, and gets that to you before the details soften.
The form beside this text is live. Fill it in and submit it — it validates exactly as it would for a real respondent, and saves nothing.
Date and time as two fields, not one timestamp
The incident date and time are separate date and time fields rather than one text box, so an incident report sorts chronologically and compares against shift schedules without anyone re-typing a timestamp into a spreadsheet later.
Severity as a fixed scale, not a description
A select field with a fixed scale — near miss through critical — means every report can be sorted by severity the moment it arrives, instead of reading each description to judge how urgent it is. That sorting is why a critical report does not sit in a queue behind ten near-misses.
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Incident report
Live previewHow to build this form
5 steps in the editor. Nothing here needs a paid plan.
- Add short text and email fields for the reporter's name and contact details.
- Add a date field and a separate time field for when the incident happened, and a text field for where.
- Add a select field for severity — near miss, minor, serious, critical — so reports can be sorted the moment they arrive.
- Add a required long text field for what happened, and an optional one for witnesses.
- In Settings, add a webhook so each report reaches your safety channel or system immediately, then export the set to CSV for a monthly review.
Fields in this form
8 fields, using 6 of the 19 field types available.
| Question | Field type | Required |
|---|---|---|
| Your name | Short text | Yes |
| Yes | ||
| Date of incident | Date | Yes |
| Time of incident | Time | Yes |
| Location | Short text | Yes |
| Severity | Select | Yes |
| What happened? | Long text | Yes |
| Witnesses, if any | Long text | Optional |
What goes wrong with this form
Specific to a incident report form, not general advice about forms.
Filing it a day later, from memory
The value of a timestamped incident report is that it is filed while the details are still accurate — where, when, who saw it. A report written up the next day from memory drifts, and no field here can correct for that; get the link in front of whoever was there before the shift ends.
Date and time in one text field
A single free-text field for "when" produces "this morning", "9ish" and "during the lunch rush", none of which sort against a shift roster. Two fields — a date field and a time field — are what make the incident placeable on a timeline rather than a description of one.
No severity field to sort by
Without a fixed severity scale, every report reads with equal urgency until someone opens it. A select field with a small fixed scale is what lets a critical report be found before ten near-misses, instead of after.
Questions about this form
What should an incident report form capture?
Seven things, at minimum: who is reporting, the date and time as two separate fields, the location, a severity rating, a description of what happened, and any witnesses. Splitting date and time into two fields is what makes a report sortable against a shift roster later.
Can an incident report be filed anonymously?
Not as built — the reporter's name and email are required fields here, so every report is attributable. Nothing in the product requires them to stay required; make both optional in the editor if anonymous reporting matters for your workplace, but a report with no contact field cannot be followed up on.
How quickly does an incident report reach me?
As fast as your webhook responds — add one in Settings and each report is POSTed to your own system, or an on-call channel, within five seconds of being submitted. It is a single attempt with no retries, so the report is stored in your dashboard either way and exports to CSV if the delivery is missed.
Can I sort incident reports by severity?
Yes — severity is a select field with a fixed scale, near miss through critical, so the CSV export has a real column to sort or filter on rather than a sentence to read for tone. That is what a select field over free text buys you: a critical report is findable without opening every row.