Instantaneous Death Investigation Checklist

Form Template

The Instantaneous Death Investigation Checklist is an app that is useful for cases where death occurs suddenly, especially in a workplace injury or environment.

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This app prompts a user to contact a decedent's employer, as well as their surviving spouse or dependent, or next of kin. In work-related injuries or deaths, this app prompts the user to note a description of the accident, the wages of the victim, OSHA reports, health reports, a copy of the written accident report, witness names and contact information, any law enforcement reports, EM referrals, and more. The contact with the surviving spouse/dependent/next of kin helps to user to get names and contact information for all dependents and/or guardians, relationships of dependents to the victim, a copy of the death certificate, autopsy reports, and more. For work injuries, the app goes beyond just being a checklist and has space for information about the body part injured, and victim's medical history to be noted.

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