Customer Accident Incident Report

Form Template

The Customer Accident Incident Report Mobile App is used to create a digital customer injury report on an iPhone, iPad or

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Android device, or tablet. Designed for use right where the incident occurred, the digital form can be completed by a store supervisor or other company representative, with the customer and/or EMT staff and security guard present.

Capture all information and contributing factors including injured person's name, details of the incident, seriousness of injury, lighting conditions, signage, employee on scene, etc.

Customize the form to your company's needs but be sure to include additional information such as damage to store, if there was an injured worker, whether it was a security incident, and if a vehicle was involved. Make sure to include corrective action information as well.

There is no need to "write an incident report" on paper - the digital accident or incident template makes it easy to manage all aspects of the incident investigation. Once completed, each party can sign off electronically then save it to the GoCanvas Cloud. Generate a PDF report and submit electronically to the insurance claims rep, the customer, the HR manager, and other required parties for the follow-up accident investigation and to create the incident response plan.

Features
  • Submission Editing
  • Reference Data
  • Dispatch
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Platforms
  • iPhone
  • iPad
  • Android
  • Windows
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Integrations
  • Quickbooks
  • Salesforce
  • Google Docs
  • Dropbox
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*The Capterra SoftwareAdvice ​and GetApp logos are a service mark of Gartner, Inc. and/or its affiliates and is used herein with permission.*

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“I’m not a tech guy and I was able to pick this thing up in probably an hour, and actually start to build apps. I’ve done them over lunch when I’ve gotten frustrated with a process that didn’t exist in our company. So for non tech people who’ve got a problem, the support here is awesome and I’d recommend it to anybody, not just in our industry.”

Dave Kramer, PennLine Service

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