Employee Incident Report Form

Makes it easy for staff to flag unsafe conditions using the R.A.D.A.R method: recognize the risk, assess the situation, plan, act and record the outcome. Supervisors receive every alert instantly.

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R.A.D.A.R report details

Name of the employee who found the R.A.D.A.R

Nombre

Apellido

Was anyone else part of resolving the R.A.D.A.R?

Nombre

Apellido

In which location do you work?

Where the unsafe condition was observed

R. Recognize the risk. What was the potential problem?

A. Assess the situation. What needs to be done to correct the problem?

D. Develop a plan. How will the unsafe condition be addressed?

A. Take action. What did you do to correct the unsafe condition?

R. Record and report. What was the end result? Was the issue corrected?

Date

Thank you for helping keep our workplace safe

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