---
title: Safety Incident form
description: The following table describes the field values for the safety incident form.
locale: en-US
canonical_url: https://www.servicenow.com/docs/r/australia/industrial-connected-workforce/digital-factory-workspace/icw-safety-incident-form.html
release: australia
product: Digital Factory Workspace
classification: digital-factory-workspace
topic_type: reference
last_updated: "2026-03-12"
reading_time_minutes: 1
breadcrumb: [ICW Health and Safety Integration, Reference, Digital Factory Workspace, Industrial Connected Workforce]
---

# Safety Incident form

The following table describes the field values for the safety incident form.

| | |
|---|---|
|Number|Auto-generated unique identifier for the safety incident.|
|Short description|Brief summary of the safety incident. Required.|
|State|Current state of the incident \(for example, New, In Progress, Closed\).|
|Severity|Severity level of the incident \(for example, Minor, Major, Critical\).|
|Occurred on|Date and time when the incident occurred.|
|Location|Location where the incident occurred. Uses cmn\_location.|
|Functional location|ICW functional location associated with the incident.|
|Category|Category classification for the incident.|
|Assignment group|Group responsible for triaging and resolving the incident.|
|Assigned to|Individual assigned to the incident.|
|Sequence of events|Rich text field capturing what happened before, during, and after the incident.|
|Origin|Reference to the originating ICW task, if the incident was created from an existing task.|

**Parent Topic:**[ICW Health and Safety Integration reference](https://raw.githubusercontent.com/ServiceNow/ServiceNowDocs/australia/markdown/australia/industrial-connected-workforce/digital-factory-workspace/icw-health-and-safety-integration-reference.md)