Witness Worker Statement (Word Format Download)

Ensuring workplace safety and accountability is crucial in construction and industrial environments. Our Witness Worker Statement Form provides a structured format to capture key details about workplace incidents from eyewitnesses, helping to improve investigations and compliance.

Why Use This Form?

• Accurate Documentation: Ensures all necessary details about the incident are recorded from a witness’s perspective.

• Regulatory Compliance: Assists in meeting OSHA and industry safety standards.

• Workplace Safety Improvement: Helps identify hazards and prevent future accidents.

• Legal & Insurance Protection: Provides an official record of events in case of disputes or claims.

Key Sections Included

• General Information: Witness details, job site location, employer, and supervisor information.

• Incident Details: Sequence of events, location, other individuals involved, and witness observations.

• Safety & Environmental Conditions: Documentation of hazardous conditions, weather, and lighting.

• Additional Information: Space for any other relevant observations.

• Sketch of Incident: A dedicated section to illustrate the incident scene.

• Witness & Supervisor Certification: Signatures to validate the statement.

Download & Use the Form Today

Ensure proper documentation of workplace incidents with our Witness Worker Statement Form. Click below to access the form and integrate it into your safety and compliance processes.