Witness Statement Form

Witness Statement Form

This incident report template can assist your business comply with aspects of ISO 45001, Management Systems clause 10.2. Incident, Non-Conformity and Corrective Actions.


– Price Includes All Taxes


What is a Witness Statement Form?

Witness Statement

A witness statement form is a document that is used to record the observations and declarations of a witness. The form can be used in incident investigations and legal proceedings and may be used to record the statements of both incident victims and witnesses.

The form typically includes questions about the witness’s personal information, what they saw or heard and any other relevant information about the incident.

How to Write a Witness Statement

A witness statement sets out what a witness has seen, heard or felt about an event or issue. It is important to get a witness statement right, as it can be used as evidence in court.

Witness Statement Form

There are a few things to remember when you are writing a witness statement:

  • Write in your own words.
  • Include everything you can remember.
  • Stick to the facts.
  • Do not include your opinions.
  • Sign and date the statement.

Witness statements and interviews should be taken as soon as possible following an incident unless this is not possible due to a serious condition.

Witnesses should be separated (if required) to enable statements to be obtained without influence.

Contents of this Witness Statement Form

This witness statement form template has provisions for the following details to be recorded and questions to be answered:

  • Witness name.
  • Employer.
  • Job role.
  • Incident date.
  • Incident location.
  • Witness details regarding the incident.
  • Describing the events leading up to the incident.
  • What conditions do you think influenced the incident.
  • How did people influence the incident.
  • In your opinion what do you think caused the incident.
  • In your opinion, how do you think the incident could have been prevented.
  • Were there any other witnesses.
  • In your opinion, were the people involved in the incident.
  • Diagrams and sketches.
  • Additional comments and observations.
  • Witness name.
  • Interviewer name.
  • Witness signature.
  • Interviewer signature.

Why Choose to Buy this Witness Statement Form

Every incident should be investigated to determine exactly how it occurred and identify the contributing factors. This 2-page witness statement form can be used to record all the witness’s details and their observations of an incident.

With these details you can determine what happened and why, and then what action to take to prevent similar incidents in the future.

After purchasing this template you will be able to:

  • Very easily edit and customize the template to create your own witness statement.
  • Apply your own style, format and brand to the witness statement.
  • Use it in any industry or sector regardless of size or type of organization.

Availability and Use of this Witness Statement Form

  • This template is accessible to you right now by clicking the ‘Buy Now’ button.
  • The template will be delivered to you in fully editable Microsoft Word format for immediate and full use in your business.
  • There are no subscriptions, contracts or ongoing costs.

Witness Statement Form Guarantee

This Witness Statement Form is 100% Satisfaction Guaranteed.


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