Use our readymade template to create this Google form. Customize it further using our form builder.
Create your Root Cause Analysis form
- Use our prebuilt template to create your Root Cause Analysis form
- Collect all essential details such as RCA Date, Location, Building/Work Area, and RCA Team
- Capture a detailed description of the event/problem and immediate actions taken
- Use the 5 Whys technique to trace the root cause of the incident
- List specific corrective and preventive actions to eliminate the root cause and prevent recurrence
Collect signatures from the employee, supervisor, and EHS Manager
- Provide a secure and seamless signing experience
- Enable the employee, supervisor, and EHS Manager to sign and submit the form from any device
- Send a confirmation email with the signed copy of the Root Cause Analysis form
- Allow users to save progress & complete the Root Cause Analysis form later
Track signed responses in Google Sheets and Drive
| A | B | C | D | E | |
|---|---|---|---|---|---|
| 1 | RCA Date | Location | Employee Name | Root Cause | Signed PDF |
| 2 | 2025-08-08 | Warehouse A | John Doe | Inadequate training | Signed PDF |
| 3 | 2025-08-07 | Office B | Jane Smith | Equipment failure | Signed PDF |
| 4 | 2025-08-06 | Site C | Robert Johnson | Violation of procedures | Signed PDF |
| 5 | 2025-08-05 | Factory D | Emily Davis | Poor communication | Signed PDF |
| 6 | 2025-08-04 | Warehouse E | William Brown | Human error | Signed PDF |
| 7 | 2025-08-03 | Office F | Elizabeth Miller | Inadequate maintenance | Signed PDF |
| 8 | 2025-08-02 | Site G | James Wilson | Environmental conditions | Signed PDF |
| 9 | 2025-08-01 | Factory H | Jessica Moore | Fatigue or stress | Signed PDF |
| 10 | 2025-07-31 | Warehouse I | Michael Taylor | Time pressure | Signed PDF |
| 11 | 2025-07-30 | Office J | Sarah Anderson | Design or layout issues | Signed PDF |
- Sync the signed Root Cause Analysis form to your Google Drive for record keeping
- Easily track and manage your form responses using the Kanban board
- Automatically receive a copy of the signed Root Cause Analysis form by email
- Sync form responses with signatures to Google Sheets for further analysis
- Notify your team by email when a Root Cause Analysis form is submitted
These reviews are reproduced without modification from Google Workspace Marketplace.
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July 12, 2023
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February 16, 2024
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