[Company Name/Logo]
Critical Incident Report
Critical Incident Description
Incident Description:
Immediate Actions Taken
Actions Taken:
Long-Term Impact
Impact Analysis:
Corrective Measures
Measures Taken:
Critical Incident Summary Table:
| Detail | Description |
|---|---|
| Incident Description | [Describe Incident] |
| Immediate Actions | [Describe Actions Taken] |
| Long-Term Impact | [Describe Impact] |
| Corrective Measures | [Describe Measures Taken] |
Reported By:
Name: ____________________________________
Position: _______________________________
Signature: _______________________________
Date: ___________________________________