Get Form

A LegalZoom Workplace Injury and Illness Incident Report gives you:

  • Essential Documentation

    Keep track of accidents to protect your company from later lawsuits and make your office safer for everyone who works there.

  • Do's & Don'ts

    Learn about important steps to take in the report process.

  • Sample Report

    Use this report to capture all pertinent information.

Unlimited Access



Unlimited access to our entire library

Get Started

Unlimited Access + Attorney Support

Starting at


Business Advantage Pro Attorney Plan

Get Started

Your subscription benefits will continue at the price and term selected at checkout until canceled.
Cancel at any time with no further obligation either online or by calling (877) 818-8787.

Already a subscriber?

Login to your account

Learn more about Workplace Injury and Illness Incident Report

Your employees are some of the most valuable resources your company has, and a key component to the growth and success of your business. Unfortunately, sometimes these employees get injured or become sick on the job because of the work they're performing. When accidents happen, it's important for your company to respond quickly to the situation, and work effectively to remedy the matter and avoid future mishaps. Part of this process is filling out a detailed workplace injury and illness report. Some local governments require that all workplace injuries be reported, complete with information about how, when, and where the accident happened.

Your employees may also need the same information to get medical treatment and to qualify for benefits. In either case, having a detailed report will help. Download LegalZoom's Workplace Injury and Illness Incident Report to create record of all work-related injuries and illnesses that occur at your company.

Have questions? We have answers.

Common questions

Do I need a special software to download or view legal forms online?
You will need Microsoft Word (97 or higher) to download and use the legal documents, and Adobe Acrobat Reader to download the form instructions. You can download Acrobat Reader for free here.
Can I use the forms more than once?
You can use the form as many times as you want for personal use or, if you are an attorney, for your clients. You may not transfer the form to any other third party for their use. For more information on LegalZoom policies, see our Terms and Conditions.
When can I download my form?
You can download your form(s) immediately after your purchase has been processed. You will be taken to a page that includes a link to your form with additional download instructions. You can access the legal forms online for up to 30 days when accessed through "My Account." To do so, go to the "My Account" link at the top of LegalZoom page.
What if I need help?
Our legal forms are created by experienced attorneys who review and update them regularly, and are all backed by our 100% Satisfaction Guarantee. If you would like to enlist an independent attorney to help you, you can subscribe to one of our legal plans for $9.99/month and receive valuable legal advice, plus an array of other benefits. Whether you need help with an independent contractor agreement for your business or a promissory note, professional legal advice is available to you. To take advantage of one of our legal plans, click here.

A specialist is here to help

(888) 381-8758

We're available Mon-Fri 5am-7pm PT
and Weekends 7am-4pm PT

American FlagOur agents are based in the United States.