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Incident Investigation Form

Incident Investigation Form Template for Nigeria

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Key Requirements PROMPT example:

Incident Investigation Form

"I need an Incident Investigation Form for our manufacturing plant in Lagos, Nigeria that complies with local factory safety regulations and includes specific sections for machinery-related incidents and chemical exposure documentation, as we'll be starting new production lines in March 2025."

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Document background
The Incident Investigation Form is a crucial document required for investigating and documenting workplace incidents in Nigerian business operations. It is designed to comply with Nigerian workplace safety legislation, including the Factories Act Cap F1 LFN 2004 and related regulations. This form should be completed for any workplace accident, incident, or near-miss that could have resulted in injury, property damage, or environmental impact. The document captures essential information including incident details, witness accounts, root cause analysis, and corrective actions. It serves multiple purposes: meeting legal reporting requirements, supporting insurance claims, implementing preventive measures, and maintaining organizational safety records. The Incident Investigation Form is particularly important for industries with high safety risks and must be completed promptly following any workplace incident.
Suggested Sections

1. Incident Overview: Basic information including date, time, location, and type of incident

2. Affected Persons: Details of all persons involved, injured, or witnesses to the incident

3. Incident Description: Detailed narrative of what occurred, including sequence of events

4. Initial Response: Immediate actions taken following the incident, including emergency response

5. Investigation Details: Investigation methodology, findings, and root cause analysis

6. Evidence Collection: List and description of all evidence gathered (photos, documents, statements)

7. Contributing Factors: Analysis of all factors that contributed to the incident

8. Recommendations: Proposed corrective actions and preventive measures

9. Investigation Team: Details of personnel conducting the investigation

10. Sign-off: Approval section for relevant authorities and investigation team

Optional Sections

1. Environmental Impact Assessment: Required when incident involves environmental damage or hazardous materials

2. Equipment/Machinery Analysis: Detailed section for incidents involving equipment failure or malfunction

3. Regulatory Reporting: Section for documenting notifications to relevant authorities, required for serious incidents

4. Cost Analysis: Assessment of financial impact, required for insurance and major incidents

5. Third Party Involvement: Details of any contractors or external parties involved in the incident

6. Medical Report Summary: Required when incident results in serious injury or health impacts

Suggested Schedules

1. Witness Statements: Collected statements from all witnesses

2. Photographic Evidence: Compiled photographs and visual evidence of the incident scene

3. Medical Reports: Copies of relevant medical documentation

4. Risk Assessment: Pre-incident risk assessment and post-incident review

5. Training Records: Relevant training and competency records of involved parties

6. Equipment Maintenance Records: Maintenance history for any involved equipment

7. Incident Scene Diagram: Sketches or diagrams showing incident location and relevant details

Authors

Alex Denne

Head of Growth (Open Source Law) @ tiktok³ÉÈË°æ | 3 x UCL-Certified in Contract Law & Drafting | 4+ Years Managing 1M+ Legal Documents | Serial Founder & Legal AI Author

alex.den.21@genieai.co
Relevant legal definitions



































Clauses

























Relevant Industries

Manufacturing

Oil and Gas

Construction

Mining

Transportation

Healthcare

Agriculture

Chemical Processing

Logistics

Maritime

Aviation

Energy

Telecommunications

Food Processing

Pharmaceutical

Relevant Teams

Health and Safety

Operations

Human Resources

Risk Management

Compliance

Quality Assurance

Facilities Management

Security

Environmental Health

Emergency Response

Legal

Medical Services

Production

Maintenance

Relevant Roles

Health and Safety Manager

Operations Manager

Site Supervisor

Risk Assessment Officer

Compliance Officer

Human Resources Manager

Facility Manager

Quality Control Manager

Production Supervisor

Environmental Health Officer

Security Manager

Plant Manager

Department Head

Safety Coordinator

Investigation Lead

Industries







Teams

Employer, Employee, Start Date, Job Title, Department, Location, Probationary Period, Notice Period, Salary, Overtime, Vacation Pay, Statutory Holidays, Benefits, Bonus, Expenses, Working Hours, Rest Breaks,  Leaves of Absence, Confidentiality, Intellectual Property, Non-Solicitation, Non-Competition, Code of Conduct, Termination,  Severance Pay, Governing Law, Entire Agreemen

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