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ACCIDENT INVESTIGATION REPORT <br />Department/Location <br />Manager <br />Affected Employee(s) <br />Type of Incident <br />Investigated by (Name/Title) <br />Gent ral n rma t n <br />Date of Incident <br />Date Investigation Initiated Date Investigation Completed <br />escn hon <br />What Occurred? <br />How did it occur? <br />When did it occur? <br />Who was involved? <br />Who witnessed incident (nafiie`and statement)? <br />What injuries (body part, action taken, etc.)? <br />What property damage. gccurred? <br />