New Report

Accident / Incident Report

Every detail filed here protects the crew, the project, and the company. Write it the way you'd want to read it six months from now.

First, secure the scene and the injured. Call 911 if anyone is seriously hurt. Document this report once the immediate response is complete.

5 coaching tips available · tap to expand

Section 01

Report Information

MASCI Job

Pick a current job to auto-fill name + number — or choose Custom Job to type your own.

Project Name *

Project Number

Location *

Incident Date *

Incident Time *

Date Reported

Reported By *

Supervisor / Foreman On-Site

Section 02

Classification & Severity

Incident Type *

Severity Tier *

Pick the actual outcome. For a near miss, choose Near Miss even if the potential was severe — note the potential in the description.

OSHA Recordable?

Was Work Stopped?

Section 03

Person Involved

Name · Linked to employee master*

Role / Trade

Employer

Years Experience

Body Part Affected

Nature of Injury / Illness

Treatment Provided

Medical Facility

Sent Home / Off Site?

Section 04

What Happened

Description of Incident *

Immediate Cause

Contributing Factors

Equipment involved (optional)

Link to a specific MASCI equipment unit. Improves traceability for the Safety team's corrective-action lookup.

Section 09

Photos / Evidence

Photos: 0 / min 4 required

Section 10

Signatures

Reporter Signature *

Reporter

Sign with your finger, stylus, or mouse above the line.

Supervisor Signature

Supervisor

Sign with your finger, stylus, or mouse above the line.

Status

Ready to submit · follow-up optional for this severity

Need 4 more photo(s) before you can submit