Alberta incident report template

Set up for Alberta

• After a reportable injury, illness or incident, the prime contractor or employer investigates the circumstances, prepares a report outlining them and the corrective action taken to prevent a recurrence, keeps it readily available for an officer on demand, and gives a copy to a Director and to the joint health and safety committee or health and safety representative, or, if there is neither, makes it available to workers once the investigation is completeOHS Act, s. 33 (6)
• An incident that had a likelihood of causing serious injury or illness, where corrective action may be needed to prevent a recurrence (a potentially serious incident), is investigated and reported the same way; the report is submitted online after the investigation is complete, and the scene does not have to be securedOHS Act, s. 33 (5) · Alberta.ca, Report potentially serious incidents

Also required in Alberta

These rules are about how and when you report, not the template's fields. Check them before you deliver.

• The prime contractor, or the employer if there is none, reports the time, place and nature to a Director as soon as possible when an injury, illness or incident results in a worker's death; when there is reason to believe a worker has been or will be admitted to hospital beyond emergency room or urgent care treatment; after an unplanned or uncontrolled explosion, fire or flood that causes or could cause serious injury or illness; after the collapse or upset of a crane, derrick or hoist; or after the collapse or failure of a building or structural component; the OHS Contact Centre takes these calls at 1-866-415-8690Occupational Health and Safety Act, SA 2020, c. O-2.2, s. 33 (1), (2) · Alberta.ca, Report serious injuries, illnesses or incidents
• Unless a Director, OHS officer or police officer directs otherwise, no one disturbs or works at the scene of a reportable injury, illness or incident, or alters, moves or removes related equipment, documents or information, except to attend to the ill, injured or killed, prevent further harm, or protect endangered propertyOHS Act, s. 33 (9)
• The prime contractor or employer who prepared the investigation report keeps it for at least 2 years after the injury, illness or incidentOHS Act, s. 33 (7)
• A report prepared under section 33 is not admissible as evidence in a trial, fatality inquiry or other action arising out of the injury, illness or incident, except in a prosecution for perjury or for giving contradictory evidenceOHS Act, s. 33 (8)
• Incidents at a mine or mine site specified in the OHS Code, and worker exposure to radiation over the prescribed limits, are also reported to a Director as soon as possibleOHS Act, s. 33 (3), (4)

What is in it

• What happenedWhat the person was doing just before the incident, with the tools, equipment or material used, then how the incident happened, in the order it happened.
• Injury or illness and treatmentThe part of the body affected and how, the object or substance that directly caused harm, and the first aid or medical treatment given and where.
• Damage to property, equipment or the environmentWhat was damaged, spilled or released, and how much, as the notes give it.
• Immediate actions takenWhat was done right away: first aid, emergency calls, the area made safe, equipment stopped or tagged out, and who was notified.
• CausesThe immediate cause and any underlying causes the notes identify: equipment, procedures, training, work conditions, supervision. Only what the notes support.
• Witness statementsName, Role, What they saw or said
• Corrective actionsAction, Responsible, Due, Status

Rules last reviewed October 12, 2026. Read the full Alberta incident report requirements.