Accident Report Form Excel
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Accident Report Form Excel

Accident & incident register with HSA IR1/IR3 guide, investigations and LTIFR

€69incl. VAT

From the accident book to the board report – every incident, follow-up and figure in one workbook

10sheets
IR1/IR3HSA guide
0macros
  • Register for accidents, near misses, dangerous occurrences and damage
  • HSA guide: IR1 after more than 3 days off, IR3 for dangerous occurrences
  • 'Report by' date in working days, skipping Irish public holidays
  • Printable accident report form for any event – filled in automatically
  • Investigations, root causes and corrective actions with owners and dates
  • LTIFR and days-lost rate per 100,000 hours, first aid log and claims
STARTSETTINGSINCIDENT REGISTERREPORT FORMINVESTIGATIONSCORRECTIVE ACTIONSFIRST AID LOGINSURANCE CLAIMSSTATISTICSDASHBOARD
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An accident report form that also tells you what happens next

Record every accident, near miss and dangerous occurrence once – the workbook flags what may need an IR1 or IR3, when to report by, what still needs investigating and how your injury rates are trending.

Most accident books are a pad of forms in a drawer. When someone hurts their back on a Friday, nobody is quite sure whether the HSA needs to be told, by when, or who is checking that the new lifting rule was ever put in place. Months later the insurer asks for the details and the page can't be found.

This workbook turns the accident report form into a working register. Each event gets a line: who, where, what happened, the injury and the days off normal work. It then shows whether the case looks reportable to the HSA (IR1 or IR3), a 'report by' date, the severity class and the investigation due date. Investigations, corrective actions, the first aid log and insurance claims link back to the same reference, and a printable report form, statistics per 100,000 hours and a dashboard are ready for your safety committee or management review.

Without a template

  • Paper accident book – nothing adds up at the end of the year
  • Unsure whether an absence has become reportable to the HSA
  • Investigations started but never finished
  • No injury rates to show management or the insurer

With ExcelGrand

  • One register for accidents, near misses and dangerous occurrences
  • 'Watch' while someone is off, IR1 once it is more than 3 days
  • Due dates by severity with overdue warnings
  • LTIFR, days lost and trends per month, area and kind of accident

What's in the file

START

Key figures, quick links and a step-by-step guide.

SETTINGS

Company details, 'records as at', HSA working-day guide, severity classes, your lists and Irish public holidays.

INCIDENT REGISTER

Every accident, near miss, dangerous occurrence, damage or ill-health report – with days off, HSA guide, severity and follow-up.

REPORT FORM

Printable accident / incident report form for any reference, filled in from the register, investigation and actions.

INVESTIGATIONS

Investigator, due date, root cause, lessons learned, witness statements and whether the risk assessment was reviewed.

CORRECTIVE ACTIONS

Owner, target date, status, cost and an effectiveness check for every action.

FIRST AID LOG

Every first aid treatment on site – flags cases sent home, to a GP or hospital that belong in the register.

INSURANCE CLAIMS

Employer's liability, public liability, motor and property claims – insurer notified, Injuries Resolution Board stage, reserve and payments.

STATISTICS

Hours worked per month → LTIFR, all-injury rate and days-lost rate per 100,000 hours, rolling 12 months.

DASHBOARD

Events per month, kinds of accident, areas and the injury pyramid for the last 12 months.

Take a look inside

Accident Report Form Excel – DASHBOARD
DASHBOARDEvents per month, kinds of accident, areas and the injury pyramid for the last 12 months.
Accident Report Form Excel – INCIDENT REGISTER
INCIDENT REGISTEREvery accident, near miss, dangerous occurrence, damage or ill-health report – with days off, HSA guide, severity and follow-up.
Accident Report Form Excel – REPORT FORM
REPORT FORMPrintable accident / incident report form for any reference, filled in from the register, investigation and actions.
Accident Report Form Excel – STATISTICS
STATISTICSHours worked per month → LTIFR, all-injury rate and days-lost rate per 100,000 hours, rolling 12 months.
Accident Report Form Excel – INVESTIGATIONS
INVESTIGATIONSInvestigator, due date, root cause, lessons learned, witness statements and whether the risk assessment was reviewed.
Accident Report Form Excel – CORRECTIVE ACTIONS
CORRECTIVE ACTIONSOwner, target date, status, cost and an effectiveness check for every action.
Accident Report Form Excel – FIRST AID LOG
FIRST AID LOGEvery first aid treatment on site – flags cases sent home, to a GP or hospital that belong in the register.
Accident Report Form Excel – INSURANCE CLAIMS
INSURANCE CLAIMSEmployer's liability, public liability, motor and property claims – insurer notified, Injuries Resolution Board stage, reserve and payments.
Accident Report Form Excel – SETTINGS
SETTINGSCompany details, 'records as at', HSA working-day guide, severity classes, your lists and Irish public holidays.
Accident Report Form Excel – START
STARTKey figures, quick links and a step-by-step guide.

Specifications

Format.xlsx
RequiresExcel 2016+ / Microsoft 365
Sheets10
Capacity200 events · 150 actions · 200 first aid entries
RatesPer 100,000, 200,000 or 1,000,000 hours
MacrosNone

Who is it for?

  • Construction & trades
  • Manufacturing & warehouses
  • Retail & hospitality
  • Safety officers & safety reps
  • OMCs & facilities managers

Frequently asked questions

What accidents must be reported to the HSA?

In short: fatal accidents, accidents that stop an employee or self-employed person from doing their normal work for more than 3 consecutive days (not counting the day of the accident), accidents to people not at work that need medical treatment, and listed dangerous occurrences – even when nobody is hurt. The register flags these as IR1 or IR3 as a guide; always check the HSA's current guidance for your case.

How do I write an accident report form?

Stick to the facts: date, time and exact place, who was involved and their role, what they were doing, what happened, the injury and body part, first aid or treatment given, witnesses and who reported it. Avoid guessing at blame – the causes belong in the investigation. The REPORT FORM sheet lays all of this out and fills it in from the register.

Who fills out an incident report?

Usually the injured person's supervisor or the person who saw what happened, as soon as possible after the event – with input from the injured person and witnesses where they can give it. A manager or safety co-ordinator then reviews it, decides on the investigation and, where needed, makes the report to the HSA.

How do I report an accident to the HSA?

Reportable accidents are notified on form IR1 and dangerous occurrences on form IR3, normally online at hsa.ie; fatal accidents should be notified to the HSA or the Gardaí at once. The workbook gives a 'report by' date based on the working days you set (skipping Irish public holidays) and lets you record the date reported and the HSA reference.

How is the LTIFR calculated?

Lost-time injury frequency rate = number of lost-time injuries × 100,000 ÷ hours worked. Enter the hours worked each month in STATISTICS and the workbook calculates the LTIFR, all-injury rate and days-lost rate for the year to date, the last 12 months, the previous year and a rolling 12-month trend. You can switch the base to 200,000 or 1,000,000 hours.

Does the workbook decide whether I must report?

No. The HSA columns are an automatic guide based on what you enter – the person type, outcome and days off. Some cases (contractors, work-related ill health, unusual events) are marked 'Check' because they need a judgement. It is not legal advice and does not replace the HSA's guidance or competent advice.

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Accident Report Form Excel

Accident & incident register with HSA IR1/IR3 guide, investigations and LTIFR · €69

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Accident report form and incident register in Excel for Irish workplaces – with an HSA IR1/IR3 guide and near miss reporting

An accident report form records what happened, who was involved and what was done about it. This Excel version works as an accident book, incident register and near miss register in one: each event gets a line with the injury, the days off work and an automatic guide to HSA accident reporting – IR1 for accidents, IR3 for dangerous occurrences – with a 'report by' date.

Behind the incident report form sit investigations with root causes, corrective actions, a first aid log and insurance claims, plus statistics such as the lost-time injury frequency rate. It suits Irish construction firms, factories, shops, hotels and owners' management companies that want more than a free accident report form template in Word or PDF.

Accident Report Form Excel€69