MIOSHA Form 301 – Injury and Illness Incident Report Template

MIOSHA FORM 301 – INJURY AND ILLNESS INCIDENT REPORT TEMPLATE FAQ

What is MIOSHA Form 301 – Injury and Illness Incident Report?

MIOSHA Form 301, or an equivalent incident report, is used by Michigan employers to capture detailed information about each work-related injury or illness that must be recorded on the MIOSHA Form 300 log. It typically includes who was injured, when and where the incident occurred, what the employee was doing, how the event happened, what body parts were affected, and what medical treatment was provided.

Who must complete a MIOSHA 301-style incident report?

Employers in Michigan that are required to keep OSHA/MIOSHA injury and illness records generally must complete a Form 301 or equivalent incident report for every recordable case listed on their MIOSHA Form 300 log. The form is usually completed by a supervisor, safety manager, HR representative, or other designated person, with input from the injured employee and any witnesses.

What information should be included in a MIOSHA Form 301 incident report?

A practical MIOSHA 301 incident report usually contains: employee identity and job title, hire date, incident date and time, exact location, description of the work activity at the time, a narrative of how the injury or illness occurred, the nature of the injury or illness and body parts affected, medical treatment and provider details, work restrictions or days away, and information about PPE and safety controls.

How does MIOSHA Form 301 relate to MIOSHA Forms 300 and 300A?

MIOSHA Form 300 is the establishment log that lists each recordable case for the year, and MIOSHA Form 300A is the annual summary of those cases. MIOSHA Form 301 (or an equivalent internal incident report like this template) provides the detailed background for each individual case on the log and supports accurate entries on both the MIOSHA 300 log and the MIOSHA 300A summary.

Is this MIOSHA Form 301 template legal or safety advice?

No. This MIOSHA Form 301 – Injury and Illness Incident Report Template is a general drafting aid modeled on common OSHA/MIOSHA concepts. It does not interpret Michigan law, decide whether a case is recordable, or replace official MIOSHA forms and guidance. For questions about recordkeeping obligations, reporting serious injuries or fatalities, or compliance with Michigan requirements, you should consult current MIOSHA resources or a qualified safety/HR professional or attorney.

How can AI Lawyer help with MIOSHA incident reports?

AI Lawyer can help you turn raw incident notes into a clear, well-structured MIOSHA 301-style incident report using this template — organizing employee information, incident descriptions, and follow-up actions. You remain responsible for providing accurate facts, determining whether a case is MIOSHA-recordable, and reviewing the final document. This template and any AI-generated content are for document organization only and are not legal or safety advice.