Create an Injury / Illness Report Form using Google Forms

Record all workplace injuries and illnesses, capture detailed incident information, track affected employees, and support OSHA recordkeeping requirements.

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Create an Injury / Illness Report Form using Google Forms

Record all workplace injuries and illnesses, capture detailed incident information, track affected employees, and support OSHA recordkeeping requirements.

What is an injury/illness report form?

An Injury and Illness Report Form is a mandatory tool for documenting work-related injuries, illnesses, and incidents in the workplace. Proper reporting not only ensures employee safety but also helps organizations maintain compliance with OSHA regulations, streamline investigations, and prevent future incidents.

A detailed report provides a reliable written record of workplace injuries and illnesses, including when, where, and how incidents occurred, and who was involved. Accurate documentation also supports workers’ compensation claims, liability investigations, and regulatory compliance, helping your organization reduce risk and maintain transparency.

Key Components

A comprehensive Injury and Illness Report Form should collect all essential information clearly, accurately, and in compliance with OSHA recordkeeping requirements. The form should include the following sections:

Employee information: This section gathers key details about the injured or ill employee. It includes the employee’s full name, job title or position, department, date of hire, and contact information. Collecting accurate employee data ensures proper identification and supports OSHA Form 301 documentation.
Incident details: This section records exactly when, where, and how the injury or illness occurred. It includes the date and time of the incident, the specific location within the workplace, and a factual description of the events leading up to it.
Injury/Illness details: This section identifies the nature of the injury or illness and specifies the body part or parts affected, including whether the injury occurred on the left or right side of the body. Additionally, it documents any object, equipment, or substance that caused or contributed to the employee’s injury.
Work status: This section outlines any changes to the employee’s ability to perform their job following the injury. It records whether the employee required days away from work, performed restricted duties, or needed a temporary job transfer. By documenting these details clearly, the form supports OSHA Form 300 log requirements and ensures accurate processing for workers’ compensation and return-to-work planning.
Root cause analysis: This section provides a detailed examination of the factors that led to the injury or illness, identifies the immediate cause of the incident, as well as contributing factors, which may include behavioral, environmental, or mechanical elements. Conducting a thorough root cause analysis supports long-term safety improvements and reinforces proactive workplace risk management.
Corrective and preventive actions: This section records the steps taken to address the hazard and prevent future incidents, both the immediate corrective actions implemented and the preventive recommendations. It also identifies the individuals responsible for carrying out each action, and specifies target or completion dates. Documenting these actions demonstrates organizational accountability, supports compliance with safety regulations, and helps maintain a safer workplace.
Acknowledgement: This section includes a signature widget for the reportee’s signature to confirm the accuracy of the information provided. The approval workflow can be customized as needed to meet organizational requirements, allowing supervisors or safety officers to review, verify, and formally approve the report.

Key features & benefits

Regulatory Compliance: Templates are designed with OSHA requirements in mind, ensuring all legally required information is captured accurately for full compliance with OSHA Forms 300 and 301.

Upload Attachments: Include photos of the injury site, medical evaluations, treatment records, witness statements, and diagrams to provide complete and thorough documentation of the injury or illness for investigations and compliance.

Legally Binding Signatures: Collect signatures for legal compliance and accountability. The signed incident report PDFs can serve as official documentation if needed.

Customizable Approval Workflow: Route injury and illness reports to supervisors, HR staff, or safety officers for review, verification, and formal approval, streamlining case management.

Sync to Google Sheets: Sync form responses to Google Sheets, allowing you to track incidents, analyze trends, monitor lost-time cases, and generate data-driven safety insights.

Save to Google Drive: Automatically generate and store PDF copies of Injury and Illness Reports in Google Drive to meet OSHA’s recordkeeping requirements and easy access.

Recordkeeping Compliance: Injury and illness reports must be retained for at least five years, with some medical and exposure records requiring retention for 30 years or longer.

Privacy & Security: Injury and illness reports may contain protected health information (PHI) covered by HIPAA. Mark fields as PHI to secure sensitive data, limit access and ensure compliance.

Mobile-Friendly: Enable employees to submit injury and illness reports directly from their mobile devices, including the ability to attach photos, documents, or treatment notes immediately after an incident for faster and more accurate reporting.

Conclusion

Whether you're managing a construction site, healthcare facility, manufacturing plant, or office environment, using a standardized Injury and Illness Report Form ensures accurate documentation and supports OSHA compliance. This template simplifies the reporting process, helping employees and supervisors capture essential details about work-related injuries and illnesses as soon as they happen, when information is most reliable.

Create your customized injury and illness report form and make reporting faster, easier, and more compliant.

These reviews are reproduced without modification from Google Workspace Marketplace.

4 stars

We chose Formesign to create and collect information for incoming requests for our services. We needed to capture details of client requests and get their signatures to communicate further and provide support. The product is very adaptable, but requires a fair amount of support for a client like me who isn't tech savvy. Vipin has been extremely helpful in getting us more knowledgeable with this product. We're still learning, and appreciate the tech support we continue to receive.

Karen Newberry

April 22, 2026

Thanks for the feedback, Karen! Vipin shared the friction you've hit with Drive setup and consent text editing and both are on our list to make smoother. Glad he's been able to help in the meantime. Please reach out anytime you're stuck on something.

— Mani Doraisamy

April 28, 2026

5 stars

I decided to use Formesign to help me leverage HIPAA-compliant forms for my practice website. What attracted me to use them was the design/flow of the product and the price point. I had done a good bit of research on what was out there, and as someone with a small business, I wanted to get the best bang for my buck. So far, I have been incredibly pleased with the product and how I have been able to integrate my forms into my website. Customer support and setup has been great. I have zero complaints at this time and would absolutely recommend going with Formesign if you may be in a similar situation to my own (small private practice in need of HIPAA compliant forms with a pleasing interface).

Griffin Chapple

April 5, 2026

5 stars

We are currently using Formesign for a non-profit academic research project on Chinese language teaching at the University of Queensland. We chose Formesign because it integrates smoothly with Google Forms and makes it easy to manage consent forms and research documentation within the same workflow. The features we found most valuable are the simple e-signature process, seamless Google Workspace integration, and ease of use for participants. This has made it much easier for us to collect and manage signed documents during our questionnaire survey process. So far our experience with the add-on has been very positive. It is straightforward to set up, reliable, and works well within the Google ecosystem, which is essential for academic research teams that rely heavily on Google tools. Overall, Formesign has been a practical and efficient solution for our research data collection process.

Yao Li

March 17, 2026

5 stars

This product is exactly what we were looking for. It builds on a familiar tool (Google Forms), integrates seamlessly with the Google products, and adds much needs features for managing signed documents. We had tried using Adobe Acrobat forms tool and found it to be really lacking in features, especially the need for readable responsive design for mobile devices. While there is a learning curve, it is well worth it, and the personalized, live support is exceptional in an age where you normally have to play 20 questions with a chatbot. I worked with Vipin via Google Meet and screen sharing, and he was exceptionally helpful and patient and even provided additional tips on improving the appearance of the form I had designed. Bottom line - very pleased!

Monty Morée

March 6, 2026

5 stars

Formesign Formesign had a truly transformative impact on my operations. The forms, signature process, and overall system they delivered are flawless. Everything works together intuitively, creating a level of efficiency and professionalism that has significantly elevated my business operations. Beyond the technical excellence of their work, what truly sets them apart is their commitment to customer service. Their one-on-one support was exceptional—courteous, responsive, and consistently focused on understanding and meeting my specific business needs. Vipin was my contact person. He was always available, patient, and thorough, ensuring that every detail was perfectly coordinated. I highly recommend Formesign to any organization looking to improve efficiency, accuracy, and workflow through customized systems. Their expertise, combined with their dedication to client satisfaction, makes them an outstanding partner.

Mike Balducci

February 25, 2026

5 stars

We are using Formesign for two of our signature workflows. We had assistance throughout the implementation process that surpassed our expectations. Formesign signature workflow now makes sure we get employee performance reviews and warning documentation forms signed by team member and their manager and allows for a supervisor approval along the way.

Matt West

May 4, 2026

5 stars

I chose Formesign because I needed a solution to link forms with signature capabilities. We are in the home service business and have a very large fleet of field operators. Formesign ability to link forms and gather signatures has removed the intense manual collection of this process out of our operation. Specifically, Vipin on the support side of Formesign has been valuable in advising on flow and making sure the process is lean. Formesign is...plug and play. Thank you!

Jason Crossen

November 1, 2025

1 stars

Besides the fact that one gets billed $216 monthly, Support took a long time to try and get things to work. Trying to get things signed on a form was such an issue and through out formatting. Way over priced, support that you have to wait till the next day to get one thing sorted and not sorted, back and forth the whole time. Frustrating customers and damage to business. I will not reccommend this company to anyone. Try JotForms so much better, and you can do much more for a fraction of the cost per year not per month.

Francois Ohsiek

May 30, 2025

Hi Francois, sorry you had a frustrating experience with the formatting. Just to clarify, the plan you’re on is $216 per year, not per month. You signed up for the Formesign Esignature paid plan on May 8, 2024, and since you also needed to sign agreements, we provided access to our Formesign - Fillable PDF add-on at no extra cost. Regarding formatting: when working with Google Docs templates, we recommend using lists instead of indents and setting up layouts with tables for images, rather than inserting images directly. This helps maintain proper formatting. To assist, we also created and shared a sample template as a reference. You had asked us to make edits on your behalf, which we’re not able to do for security reasons. However, we did reach out and invited you to join a scheduled Zoom call to walk through the process — as we’ve done several times over the past year — but we didn’t receive a response. Update: To make things easier for all users, we have just launched the new document editor in Formesign that will allow agreements to be created directly, without relying on Google Docs.

— Formfacade

June 3, 2025

2 stars

The platform is good but promises one week of premium usage based on which I chose it. Once my form was sent out to participants, it capped the responses at 24 and I was forced to pay 36 USD to keep the form active. Really disappointed by the lack of clarity and the overly tight response numbers for each tier of the plan considering how nice the platform could be.

Nishka Khendry

September 11, 2025

5 stars

I am not tech savvy. I chose formesign to help create registration links for clients. Vipid has been great in assisting me. He goes above and beyond. My company now has moved from the stone age to modern age through the ability to use this feature. Of the many features I am impressed with, the ability to update a form without needing to regenerate a link is amazing. I often make mistakes and that ability allows me to fix mistakes without needing to change everything. Thank you!!!

Sol Evans

July 23, 2023

Create an Injury / Illness Report Form using Google Forms