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Sample Workplace Injury Report Form in Kenya

Document Type
DOCX
Pages
3
Price: KES 200
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Document Overview

The Workplace Injury Report Form is a structured document used to record the details of an injury sustained by an employee at the workplace.

Components:
1. Employee Information
2. Injury Details
3. Description of Injury
4. Witness Information
5. Medical Attention
6. Injury Classification E.g. Minor, Moderate
7. Contributing Factors E.g. Equipment Failure
8. Corrective Actions
9. Supervisor’s Comments
10. Employee’s Acknowledgment
11. Management Review
12. Additional Notes/Comments

Purpose:
1. Acts as record of the incident
2. Assists in meeting legal obligations under workplace safety and labor laws in Kenya
3. Facilitation of Medical and Financial Support
4. Incident Investigation
5. Prevention of Future Incidents
6. Helps supervisors and HR assess the situation and take corrective actions
7. Shows employer's commitment to employee well-being and safety

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