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Witness Statement Form

Written from experience on CTRL, Crossrail and Network Rail

This witness statement form records a clear, signed account from each witness after an accident or incident on site, in their own words, with guided questions, space for a sketch, and a declaration.

Page 1 of the Witness Statement Form templateSee what you get →

Free: Free RIDDOR checklist →ClarusPM →

Template

£6 + VAT

£7.20 inc. VAT

Blank form — fill in yourself

  • Word document (.docx)
  • Guidance notes included
  • Instant download
  • Use on any project
RIDDOR reporting guide What to report, who reports it, and when.Read the guide →

Prices exclude VAT: UK customers pay 20% VAT; VAT is not charged for customers outside the UK.All documents are drafts. Complete the placeholders with your own details, and have a competent person review them before use.

What it's for

Memories fade and change quickly, and accounts start to merge once people talk to each other. Taking a separate statement from each witness as soon as possible, in their own words, gives the investigation the most reliable picture of what happened, and gives you a record if the incident is later questioned.

When you need it

As soon as possible after an accident or incident, with one form for each witness.

Who signs it

The witness signs the declaration that the statement is true to the best of their knowledge and belief. The person who took the statement also signs.

What's inside

  • Company, project, incident reference and date
  • Witness details
  • How the witness relates to the incident: saw it, heard it, first on the scene, or told by someone else
  • Guided questions: where they were, what they saw or heard, what happened next, what they did, and anything unusual beforehand
  • Space for a diagram or sketch of the scene
  • Other witnesses known to them
  • A declaration and signatures

FAQ

Should I write the statement for the witness?
Write down what they say in their own words. Do not lead them or suggest answers. The form includes a reminder.
Should witnesses be interviewed together?
No. Take each statement separately so that each person’s account is their own.
Is this a formal legal statement?
No. It is an internal record for your investigation. If the incident leads to legal proceedings, take legal advice on statements.
What if the witness cannot write their own statement?
The person taking the statement can write it down for them, in their words, then read it back and ask them to sign it if they agree it is accurate.
What are the [PLACEHOLDERS]?
Purple text in square brackets, such as [COMPANY NAME], marks the details you fill in. Replace each one with your own details, and remove anything that doesn’t apply, before the document is used.
Can I edit the document?
Yes. It’s a Word document you can edit freely.
Do I still need to review it?
Yes. A competent person must check every document against the actual site and works before it is used. ClarusDocs gives you a complete first draft, not a substitute for that check.

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