Use our readymade template to create this Google form. Customize it further using our form builder.
Get root cause analysis using Google Forms
- Use our prebuilt template to create your root cause analysis form
- Get legally binding signatures from the employee, supervisor, and EHS Manager
- Collect employee details such as Employee Name, Email, Department, and Job Title
- Specify incident details such as Location, Building/Work Area, and RCA Date
- Capture a description of the event/problem, immediate actions taken, and the 5 Whys
Collect signatures from the employee, supervisor, and EHS Manager
- Embed the form on your website or use the share link to collect responses
- Provide a user-friendly, secure and seamless signing experience
- Enable employees, supervisors, and EHS Managers 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 later
Track signed responses in Google Sheets and Drive
| A | B | C | D | E | |
|---|---|---|---|---|---|
| 1 | Employee Name | RCA Date | Root Cause | Corrective Actions | Signed PDF |
| 2 | Ava Thomas | 2025-08-08 | Inadequate training | Implement a comprehensive training program | Signed PDF |
| 3 | Liam Wilson | 2025-08-07 | Equipment failure | Regular equipment maintenance and inspection | Signed PDF |
| 4 | Noah Patel | 2025-08-06 | Violation of procedures | Enforce strict adherence to safety procedures | Signed PDF |
| 5 | Emma Johnson | 2025-08-05 | Poor communication | Improve internal communication channels | Signed PDF |
| 6 | Oliver Lee | 2025-08-04 | Human error | Implement a comprehensive training program | Signed PDF |
| 7 | Sophia Kim | 2025-08-03 | Inadequate risk assessment | Conduct regular risk assessments | Signed PDF |
| 8 | Mason Rodriguez | 2025-08-02 | Lack of supervision | Increase supervision during high-risk tasks | Signed PDF |
| 9 | Isabella Garcia | 2025-08-01 | Environmental conditions | Improve workplace environment conditions | Signed PDF |
| 10 | Elijah Brown | 2025-07-31 | Design or layout issues | Redesign workspace for better safety | Signed PDF |
| 11 | Mia Anderson | 2025-07-30 | Organizational or cultural factors | Promote a safety culture within the organization | 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 is submitted
These reviews are reproduced without modification from Google Workspace Marketplace.
July 23, 2023
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October 31, 2023
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July 12, 2023
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February 16, 2024
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November 27, 2023
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July 10, 2023
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