tiktok³ÉÈË°æ

All Countries
Compliance
Critical Incident Report Form

Critical Incident Report Form Template for Canada

Create a bespoke document in minutes,  or upload and review your own.

4.6 / 5
4.8 / 5

Let's create your Critical Incident Report Form

Thank you! Your submission has been received!
Oops! Something went wrong while submitting the form.

Get your first 2 documents free

Your data doesn't train Genie's AI

You keep IP ownership of your information

Key Requirements PROMPT example:

Critical Incident Report Form

"I need a Critical Incident Report Form for our hospital network that complies with Canadian healthcare privacy regulations and includes detailed sections for patient safety incidents, with special attention to medication errors and falls."

Celebrated by
Collaborations with
Investors
Document background
The Critical Incident Report Form is a fundamental document required by Canadian workplace safety legislation and regulatory frameworks. It serves as an official record of significant workplace incidents, accidents, injuries, or near-misses that require formal documentation and potential regulatory reporting. The form is designed to capture comprehensive information about the incident, including circumstances, involved parties, immediate actions taken, and follow-up measures required. This document is essential for compliance with various Canadian federal and provincial regulations, including the Canada Labour Code, provincial Occupational Health and Safety Acts, and industry-specific safety requirements. It also supports internal risk management, insurance claims, workers' compensation processes, and continuous improvement of safety protocols. The Critical Incident Report Form must be completed promptly following any significant incident and maintained as part of the organization's safety records.
Suggested Sections

1. Incident Identification: Basic details including date, time, location, and incident reference number

2. Reporter Information: Details of the person completing the report, including name, position, contact information, and relationship to the incident

3. Incident Classification: Category and severity level of the incident based on standardized classification criteria

4. Incident Details: Comprehensive description of what occurred, including sequence of events and immediate actions taken

5. Persons Involved: Information about all individuals involved, including victims, witnesses, and responders

6. Immediate Response Actions: Details of emergency response procedures implemented and immediate steps taken to control the situation

7. Impact Assessment: Evaluation of the incident's impact on people, property, operations, and environment

8. Root Cause Analysis: Initial assessment of factors contributing to the incident

9. Corrective Actions: Immediate and planned actions to prevent recurrence

10. Notifications Made: List of all parties notified of the incident, including timestamps and methods of communication

Optional Sections

1. Environmental Impact: Detailed assessment of environmental effects and compliance with environmental regulations, required for incidents involving environmental hazards

2. Equipment/Property Damage: Detailed description of damage to equipment or property, including cost estimates, required when physical assets are affected

3. Medical Response Details: Specific information about medical treatment provided, required for incidents involving injuries or health issues

4. Security Breach Details: Information about security-related aspects, required for incidents involving security breaches or unauthorized access

5. Media/Public Relations: Documentation of media involvement and public communications, required for high-profile incidents

6. Regulatory Compliance: Specific details required for regulatory reporting, included when incident falls under specific regulatory requirements

7. Business Continuity Impact: Assessment of impact on business operations and continuity plans, required for incidents affecting operational capability

Suggested Schedules

1. Appendix A - Incident Scene Documentation: Photos, diagrams, or sketches of the incident scene

2. Appendix B - Witness Statements: Standardized forms containing detailed witness accounts

3. Appendix C - Evidence Log: Detailed log of all evidence collected related to the incident

4. Appendix D - Medical Reports: Copies of relevant medical documentation and first aid reports

5. Appendix E - Risk Assessment Matrix: Standard risk assessment tool for incident classification

6. Appendix F - Notification Checklist: Standard checklist for required internal and external notifications

7. Appendix G - Investigation Follow-up Form: Template for documenting subsequent investigation findings and actions

8. Appendix H - Relevant Procedures: Copies of relevant standard operating procedures or emergency response protocols that were activated

Authors

Alex Denne

Head of Growth (Open Source Law) @ tiktok³ÉÈË°æ | 3 x UCL-Certified in Contract Law & Drafting | 4+ Years Managing 1M+ Legal Documents | Serial Founder & Legal AI Author

alex.den.21@genieai.co
Relevant legal definitions








































Clauses



























Relevant Industries

Healthcare

Manufacturing

Construction

Mining

Transportation

Energy

Education

Retail

Hospitality

Chemical Processing

Agriculture

Forestry

Public Services

Telecommunications

Financial Services

Warehousing and Distribution

Relevant Teams

Health and Safety

Operations

Human Resources

Risk Management

Security

Emergency Response

Quality Assurance

Environmental Compliance

Legal

Facilities Management

Employee Relations

Occupational Health

Training and Development

Relevant Roles

Health and Safety Coordinator

Site Supervisor

Department Manager

Facility Manager

Risk Management Officer

Safety Officer

Human Resources Manager

Operations Manager

Shift Supervisor

Security Manager

Environmental Compliance Officer

Quality Assurance Manager

Plant Manager

Project Manager

Emergency Response Coordinator

Occupational Health Nurse

Department Head

Chief Operating Officer

Workplace Safety Inspector

Industries








Teams

Employer, Employee, Start Date, Job Title, Department, Location, Probationary Period, Notice Period, Salary, Overtime, Vacation Pay, Statutory Holidays, Benefits, Bonus, Expenses, Working Hours, Rest Breaks,  Leaves of Absence, Confidentiality, Intellectual Property, Non-Solicitation, Non-Competition, Code of Conduct, Termination,  Severance Pay, Governing Law, Entire Agreemen

Find the exact document you need

Security Guard Report Form

A standardized Canadian security incident reporting document used to record security-related events, observations, and actions taken by security personnel, compliant with provincial and federal regulations.

find out more

Patient Safety Incident Reporting Form

A standardized Canadian Patient Safety Incident Reporting Form for documenting and reporting healthcare safety incidents in compliance with federal and provincial regulations.

find out more

Incident Notification Form

A Canadian-compliant Incident Notification Form for documenting and reporting various types of incidents, aligned with federal and provincial requirements.

find out more

Health And Safety Incident Report Form

A standardized Canadian workplace incident reporting form that complies with federal and provincial health and safety regulations for documenting workplace accidents, injuries, and safety events.

find out more

Hazard Report Form

A Canadian-compliant workplace hazard reporting document for systematically recording and addressing safety concerns in accordance with federal and provincial regulations.

find out more

Hazard Incident Report Form

A standardized Canadian workplace incident reporting form for documenting hazards, accidents, and near-misses in compliance with federal and provincial safety regulations.

find out more

Work Place Injury Report Form

Canadian-compliant workplace injury report form for documenting work-related incidents and injuries, meeting federal and provincial safety regulations.

find out more

Employee Incident Report Form

A standardized Canadian workplace incident reporting form for documenting occupational accidents, injuries, and near-misses in compliance with federal and provincial regulations.

find out more

Critical Incident Report Form

A standardized Canadian workplace incident documentation form that complies with federal and provincial safety regulations for recording and reporting significant workplace events.

find out more

Security Incident Report Form

A Canadian-compliant Security Incident Report Form for documenting and managing security incidents while meeting federal and provincial regulatory requirements.

find out more

Incident Response Form

A Canadian-compliant form for documenting and managing security incidents, ensuring alignment with PIPEDA and provincial privacy requirements.

find out more

Incident Investigation Form

A standardized Canadian workplace incident investigation and documentation form compliant with federal and provincial health and safety regulations.

find out more

Download our whitepaper on the future of AI in Legal

By providing your email address you are consenting to our Privacy Notice.
Thank you for downloading our whitepaper. This should arrive in your inbox shortly. In the meantime, why not jump straight to a section that interests you here: /our-research
Oops! Something went wrong while submitting the form.

³Ò±ð²Ô¾±±ð’s Security Promise

Genie is the safest place to draft. Here’s how we prioritise your privacy and security.

Your documents are private:

We do not train on your data; ³Ò±ð²Ô¾±±ð’s AI improves independently

All data stored on Genie is private to your organisation

Your documents are protected:

Your documents are protected by ultra-secure 256-bit encryption

Our bank-grade security infrastructure undergoes regular external audits

We are ISO27001 certified, so your data is secure

Organizational security

You retain IP ownership of your documents

You have full control over your data and who gets to see it

Innovation in privacy:

Genie partnered with the Computational Privacy Department at Imperial College London

Together, we ran a £1 million research project on privacy and anonymity in legal contracts

Want to know more?

Visit our for more details and real-time security updates.

Read our Privacy Policy.