Oregon incident report template

Oregon rules for this report

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

• Work-related fatalities (including heart attacks at work and motor vehicle accidents during the work shift, if death occurs within 30 days) and catastrophes (two or more employees killed, or three or more admitted to a hospital or equivalent facility from the same incident) are reported to Oregon OSHA in person or by telephone within 8 hours of occurrence or of the employer learning of themOAR 437-001-0704 (3)
• In-patient hospitalizations, losses of an eye, and amputations or avulsions with bone or cartilage loss are reported to Oregon OSHA within 24 hours of the incident or of the employer learning of them (a single report when they come together); hospitalization for observation only and emergency room treatment are not reportable, but admission for any reason after emergency room treatment is, including heart attacks and motor vehicle accidentsOAR 437-001-0704 (4)
• Oregon OSHA's Salem central office takes reports at (503) 378-3272, toll free in Oregon (800) 922-2689, and field offices in Bend, Eugene, Medford, Pendleton, Portland and Salem take reports by phone or in personOAR 437-001-0704, office list
• Each employer investigates, or has investigated, every lost time injury workers suffer in connection with their employment to determine how to prevent a recurrence, and promptly installs any safeguard or takes any corrective measure found advisableOAR 437-001-0760 (3) (a)
• When the department asks, employers, superintendents, supervisors and employees furnish all pertinent evidence and the names of known witnesses, and those in direct authority preserve and mark for identification the materials, tools or equipment needed for the investigationOAR 437-001-0760 (3) (b)
• Reporting a work-related injury, illness or fatality does not assign fault, does not prove the violation of an OSHA rule, and does not establish eligibility for workers' compensation or other benefitsOAR 437-001-0704 (1), note

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 Oregon incident report requirements.