SMALL BUSINESS INTERNATIONAL TRAVEL RESOURCE

TRAVEL PLANNER

Employer and Employee Planning Tool for Safe and Healthy Employee Travel
This document is the public domain and may be freely copied or reprinted.

Disclaimer

Mention of any company or product does not constitute endorsement by the 

National Institute for Occupational Safety and Health, Centers for Disease Control 

and Prevention. In addition, citations to websites external to NIOSH do not constitute 

NIOSH endorsement of the sponsoring organizations or their programs or products. 

Furthermore, NIOSH is not responsible for the content of these websites. All web 

addresses referenced in this document were accessible as of the publication date.

Get More Information

Find NIOSH products and get answers to workplace safety and health questions:

1-800-CDC-INFO (1-800-232-4636) | TTY: 1-888-232-6348

CDC/NIOSH INFO: cdc.gov/info | cdc.gov/niosh

Monthly NIOSH eNews: cdc.gov/niosh/eNews

Suggested Citation

NIOSH [2019]. Small business international travel resource. By Van Bogaert D, Kitt M, 

Yeoman K, Chosewood C, Gibbins J, Nickels L, Piacentino J, Novakovich J. Cincinnati, 

OH: U.S. Department of Health and Human Services, Centers for Disease Control 

and Prevention, National Institute for Occupational Safety and Health, DHHS (NIOSH) 

Publication 2019-165.

Acknowledgements

Special thanks to — Elizabeth Clements, Vanessa Williams, Tony Trucco, 

Stephanie Pratt, Lisa Delaney, TJ Lentz, John Lechliter, Matt Tennant 

DHHS (NIOSH) Publication No. 2019-165 

DOI: https://doi.org/10.26616/NIOSHPUB2019165

August 2019
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SMALL BUSINESS INTERNATIONAL TRAVEL RESOURCE

TRAVEL PLANNER

Table of Contents

Part 1: Assessments and Action Planning for Pre-travel, On-travel, and Post-travel ............. 1

Section A: Pre-travel Planning .................................................... 1

Pre-travel: Job Plan ......................................................... 1

Pre-travel: Location Plan...................................................... 3

Pre-travel: Personal Plan (For Employee) ......................................... 4

Section B: On-travel Planning .................................................... 7

On-travel: Job Plan.......................................................... 7

On-travel: Location Plan...................................................... 7

On-travel: Personal Plan...................................................... 8

Section C: Post-travel Plan....................................................... 9

Post-travel: Job Plan......................................................... 9

Post-travel: Location Plan .................................................... 9

Post-travel: Personal Plan..................................................... 10

Part 2: Travel Planning Tools ........................................................ 11

Employer Task Timeline ......................................................... 13

Travel Health Assessment........................................................ 15

Location Health and Safety Plan .................................................. 19

Packing List................................................................... 21

Contact and Emergency Information Form .......................................... 27

Incident Report................................................................ 29

Post-travel Report ............................................................. 31
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TRAVEL PLANNER

Part 1: Assessments and Action Planning for Pre-travel, 

On-travel, and Post-travel

Part 1 provides a checklist for planning at each of the three travel stages in three critical areas: job, location, and 

personal. Each travel stage checklist provides questions to help identify key risks, considerations, and actions 

that need to be addressed before, during and after your employee’s travel.

Section A: Pre-travel Planning

PRE-TRAVEL: JOB PLAN

Employees may face different conditions, exposures, or hazards at international worksites. A pre-travel 

conversation between the employer and employee is an important step in preparing for travel health and safety. 

The following questions will help you and your employee identify job-specific needs that may require action or 

planning before departure.

Applies

Y/N Preparation

Follow Up

Actions Resource Timeline

1.A.1 Will job differences require more 

training for employee?

1.A.2 Are there differences in health and 

safety rules that employee will 

need to know?

1.A.3 Will hazards and hazard controls 

be different? If so, what will be 

different or new for employee?

1.A.4 Will there be adequate controls in 

place to prevent employee exposure to hazards?

1.A.5 Will employee need personal protective equipment (PPE)? If yes, 

will PPE be different than PPE 

used in employee’s home job? 

Does employee need to bring 

PPE or will it be available at international site? Will employee need 

PPE training?
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Applies

Y/N Preparation

Follow Up

Actions Resource Timeline

1.A.6 Will there be language differences? If so, what arrangements 

are needed?

1.A.7 Will employee need to be briefed 

on workplace customs and 

culture? Who will do that?

1.A.8 Is there a procedure for reporting 

an accident or incident? Download 

customizable Incident Report.

1.A.9 Discuss any samples, PPE or 

equipment that the employee may 

need to take to the international 

job location. See Travel.State.Gov: 

Before You Go for information on 

customs and import restrictions. 

1.A.10 If employee will be carrying

samples of hazardous material 

(dangerous goods), these must 

comply with the International 

Airline Transport Association (IATA) 

specifications. See IATA Standards, 

manuals and guidelines.
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PRE-TRAVEL: LOCATION PLAN

Factors that can affect the employee location experience include geography, climate, and local culture. 

Depending on work location, the employee may require vaccinations. If traveling to multiple locations, the 

employee may also need region-specific information on climate or extreme weather, transportation, and 

security. Use the following questions to help your employee identify location-specific needs that may require 

action or planning before departure. 

Applies

Y/N Preparation

Follow Up

Actions Resource Timeline

1.A.11 Will employee be exposed to 

excessive heat, cold, or high altitude? If so, will temperature or 

altitude extremes require special 

clothing or time to adjust?

1.A.12 Will season be different from 

home? If so, will weather conditions require special clothing?

1.A.13 Is employee traveling during 

hurricane or typhoon season? If 

so, will employee need special 

emergency plans?

1.A.14 Are natural disasters common 

at work destination? If so, will 

employee need special emergency 

plans or training?

1.A.15 Will workplace or location air 

quality make it difficult to work or 

participate in outdoor activities? 

If so, will employee need personal 

protective equipment (PPE)?

1.A.16 How will employee travel to 

worksite? If by car, will there be 

a driver? Is public transportation 

available and safe to use?
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PRE-TRAVEL: PERSONAL PLAN (For Employee)

Make sure to assist the employee in planning for personal well-being. While on travel, personal concerns can 

cause stress. Often new health conditions come up and ongoing issues get worse. Discuss with your employee 

the importance of talking to a healthcare provider about all health concerns before leaving on international 

work travel.

Applies

Y/N Preparation

Follow Up

Actions Resource Timeline

HEALTH CONCERNS

1.A.17 What medical services will be 

available on-travel? See U.S. 

Department of State’s Travel.

State.Gov–Country Information, choose “Destination”, and 

select “Health”.

Travel.State.

Gov-Country

Information

1.A.18 Are there travel clinic services 

available through your small 

business? If not, contact a local 

hospital or public health department for referral to a travel 

medicine healthcare provider. 

Let employee know if travel clinic 

services are available. 

For information on 

travel clinics, go to 

the International 

Society of Travel 

Medicine or the 

American Society 

of Tropical Medicine and Hygiene.

Schedule an evaluation six weeks 

before travel.

1.A.19 Will employee have health insurance coverage while traveling? 

Confirm that health insurance will 

be available.

Consider purchasing supplemental 

travel health insurance and medical evacuation insurance.

Travel.State.Gov–Your 

Health Abroad 

U.S. Department 

of State

International SOS

MEDEX

International 

Association for 

Medical Assistance 

to Travelers

1.A.20 Will employee be travelling across 

five or more time zones? See 

Jet Lag.
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TRAVEL PLANNER

Applies

Y/N Preparation

Follow Up

Actions Resource Timeline

PACKING AND OTHER SPECIAL TRAVEL CONCERNS

1.A.21 Make sure employee knows what 

to pack. See Packing List.

1.A.22 Will employee be traveling 

with children? See Traveling 

with Children.

1.A.23 Will employee be traveling with 

pets? See Traveling with Pets.

USDA: Pet Travel

USDA Traveling 

with your Pets

U.S. Department 

of State: Pets and 

International Travel

FINANCIAL AND LEGAL PLAN (FOR THE EMPLOYEE)

1.A.24 Have you notified your bank 

and other financial institutions, including credit cards, of 

all destinations? 

1.A.25 Have you setup online 

banking accounts?

1.A.26 Do you know what transaction 

fees might accrue from using ATM 

and credit cards? Look for cards 

without foreign transaction fees.

1.A.27 Do you have multiple forms of 

payment available for travel? 

Bring cash, credit card, and traveler’s checks. Travel with $200 

to $300 in small denominations 

of cash.

1.A.28 Have you arranged to have 

someone pay your bills and hold 

or forward mail to new location, based on how long you will 

be away?
SMALL BUSINESS INTERNATIONAL TRAVEL RESOURCE

TRAVEL PLANNER

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Applies

Y/N Preparation

Follow Up

Actions Resource Timeline

1.A.29 Do you have a will and have you 

selected a power of attorney?

1.A.30 If you are a small family-owned 

business, have you planned for 

sucession and scheduled separate 

flights for family members?
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Section B: On-travel Planning

Once arriving in a country, the employee should review the pre-travel plan and continue to check it as 

conditions change, or every 2 to 4 weeks. The employee should pay particular attention to new situations. 

The following questions will help the employee identify needs and concerns to address.

ON-TRAVEL: JOB PLAN

Applies

Y/N On-travel Concerns

Follow Up

Actions Resource Timeline

JOB

1.B.1 Is the job what you expected and 

will it change over time? Does this 

require changes to your plan?

1.B.2 Will you need personal protective 

equipment (PPE) for the job?

1.B.3 Do you have a plan for communicating with local home office, 

and co-employees?

ON-TRAVEL: LOCATION PLAN

Applies

Y/N On-travel Concerns

Follow Up

Actions Resource Timeline

LOCATION

1.B.4 Has primary location of your 

travel changed?

1.B.5 Do you have to travel to more 

than one location?

1.B.6 Are there any additional risks at 

new locations?

1.B.7 Are security and evacuation plans 

still feasible and adequate?

1.B.8 How will new work locations 

impact post-travel period?
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Applies

Y/N On-travel Concerns

Follow Up

Actions Resource Timeline

1.B.9 Are accommodations safe 

and adequate?

1.B.10 Are food and water sources safe? 

Don’t eat street food! 

1.B.11 What are your transportation 

plans, including primary and 

remote locations?

ON-TRAVEL: PERSONAL PLAN

Applies

Y/N On-travel Concerns

Follow Up

Actions Resource Timeline

PERSONAL

1.B.12 Has your personal health changed 

since departure?

1.B.13 Do you have enough medication? 

1.B.14 Do you need to stop taking 

any medication?

1.B.15 Are medical services in country 

as expected? Do you need additional assistance?

1.B.16 Do you have any new medical 

conditions or symptoms that will 

need evaluation after your travel 

is completed?

1.B.17 Have you developed or discovered health risks you didn’t 

know about?
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Section C: Post-travel Plan

Typically, the employee focuses the most energy on getting to the destination. As the work assignment ends, 

focus should begin shifting to work closure activities and transitioning to daily life at home.

POST-TRAVEL: JOB PLAN

Applies

Y/N Post-travel Concerns

Follow Up

Actions Resource Timeline

JOB

1.C.1 Have you collected information 

needed to complete post-travel 

report? See Post-Travel Report.

1.C.2 Inform your employer about any 

following work-related incidents 

that may have occurred during 

travel:

•	 Injuries or illnesses

•	 Motor vehicle crashes

•	 Security incidents, violence, 

or crime

•	 Legal issues

•	 Workplace-specific exposures 

to chemicals, physical 

hazards, or infectious 

diseases

POST-TRAVEL: LOCATION PLAN 

Applies

Y/N Post-travel Concerns

Follow Up

Actions Resource Timeline

LOCATION

1.C.3 Have you made plans to share 

your experiences with others and 

future travelers?

1.C.4 Have you set aside time to think 

about what went well and what 

could be improved?
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POST-TRAVEL: PERSONAL PLAN

Applies

Y/N Post-travel Concerns

Follow Up

Actions Resource Timeline

PERSONAL BEFORE RETURN

1.C.5 Did you say goodbye to people 

you met at work who meant a lot 

to you?

1.C.6 Have you found ways to keep in 

touch with them?

PERSONAL AFTER RETURN

1.C.7 Have you planned to rest, recuperate, and adjust?

1.C.8 Have you shared your experiences 

with others and future travelers?

1.C.9 Have you set aside time to 

document what went well and 

what could be improved?
PART 2: TRAVEL PLANNING TOOLS

Part 2 provides a series of forms to help you assess or document information during each of the planning stages.
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EMPLOYER TASK TIMELINE

Employer Task Timeline

This task timeline provides a process for thinking about and planning your employee’s safe and healthy 

travel. The process begins by considering what professional services you will need to protect your employee 

and your business during international travel. Once risks and liabilities have been addressed, this resource can 

be used to guide employee communication and travel planning. The timeline includes tips to enhance business 

and personal experiences. If your business requires emergency or unanticipated travel, the sequence of tasks 

remains the same. The timeline will provide a valuable reference in any travel situation.

Timeline Work Travel Planning Tasks 

 3 months before travel 1.1 Review your company risks and liability with company counsel and

prepare necessary paperwork and releases.

 1.2 Meet with your employee to review the Small Business International 

Work Travel Planner: Pre-travel, On-travel, and Post-travel sections. 

Identify future action items.

 1.3 Confirm your employee’s passport will be active for the full duration of 

the trip. Plan for personal travel visas while on assignment and make 

sure there are enough blank VISA pages (at least two).

 1.4 Visit the U.S. State Department and CDC Travel websites to find current safety and health information on the host country. Determine if 

your employee should see an occupational physician before travel. 

If so, identify a local occupational physician for an exam and necessary vaccinations.

 1.5 Contact key partners and collaborators that you will need in the destination country. 

 1.6 Discuss with employee any samples, PPE or equipment that the 

employee may need to take to the international job location. See 

Travel.State.Gov: Before You Go for information on customs and 

import restrictions. 

 1.7 If your employee will be carrying samples of hazardous material 

(dangerous goods), you must comply with the International Airline 

Transport Association (IATA) specifications. See IATA Standards, 

manuals and guidelines.

 2 months before travel 2.1 Contact the Office of Business and Commercial Affairs–Department

of State for information on the business culture of the country in which 

your employee will be working. The State contact may also be 

a source of business contacts. 
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EMPLOYER TASK TIMELINE

Timeline Work Travel Planning Tasks 

 2.2 Meet with your employee to discuss progress on the Small Business 

International Work Travel Planner to meet critical deadlines.

 1 month before travel 3.1 Review the CDC travel, U.S. State Department, World Weather Information Service websites to discover conditions that may affect health 

and safety on travel.

 3.2 Meet with your employee to establish expectations for contact while 

on travel.

 3.3 Review contingency plans with your employee.

 3.4 Confirm that both you and your employee have a copy of the Small 

Business International Work Travel Planner. Confirm that the employee 

has completed the personal section of the planner.

 During travel 4.1 Hold planned check ins. Phone or SKYPE conversations can confirm 

that your employee is doing well.

 1 week after travel 5.1 Meet with your employee to debrief. Document accomplishments, 

lessons learned, and review any incident or special reports. Determine 

whether a status physical or other medical review are necessary. 

 2 weeks after travel 6.1 Collect final reports from your employee and close the travel file.
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TRAVEL HEALTH ASSESSMENT

Travel Health Assessment

Have your employee complete the Travel Health Assessment Part 2 with the employee’s health care provider. 

The form contains confidential information that should not be shared with the employer. It’s important to 

complete this form to ensure safe and healthy work travel. 

Applies

Y/N Concerns

Follow Up

Actions Resource Timeline

2.A.1 Do you need vaccines? Even if you 

make last-minute travel plans, seek 

a health provider for vaccinations. 

Seek a pre-travel consultation at 

least 4–6 weeks before departure to 

allow enough time for protection to 

develop from vaccines.

2.A.2 Do you have any existing or new 

health conditions? Seek guidance 

from a qualified healthcare professional to determine if it is safe 

to travel. 

2.A.3 Do you have an existing illness that 

could suddenly incapacitate you? 

Inform your supervisor and a travel 

companion. Let companion know 

what to do if you become incapacitated. Also, consider wearing 

medical alert bracelet. 

2.A.4 Have you addressed any chronic 

health conditions before traveling? 

See CDC Yellow Book for information on specific chronic health 

problems. Ask healthcare 

provider if it is safe to travel.

2.A.5 Do you know who to alert about any 

health conditions? Seek guidance 

from healthcare provider.

2.A.6 Do you have enough medications 

for entire trip? Seek guidance from 

healthcare provider.
SMALL BUSINESS INTERNATIONAL TRAVEL RESOURCE

TRAVEL HEALTH ASSESSMENT

16 | Travel Planner — Part 2

Applies

Y/N Concerns

Follow Up

Actions Resource Timeline

2.A.7 Do you have a health problem that 

needs regular monitoring? Seek 

guidance from healthcare provider.

2.A.8 Do you have a condition that 

required a hospital stay within past 

year? Seek guidance from healthcare provider.

2.A.9 Do you have an illness or condition that can get worse quickly and 

interfere with work or travel (such 

as diabetes, seizure disorder, or 

asthma)? Seek guidance for travel 

from healthcare provider.

2.A.10 Have you had surgery or been

prescribed surgery or a diagnostic 

procedure? Seek guidance from 

healthcare provider.

2.A.11 Have you discussed with healthcare

provider a plan with instructions for 

managing any changes in or worsening of health conditions while 

on travel? 

2.A.12 Will you be traveling with medications? Pack copy of recent health 

summary or doctor’s letter on letterhead describing medical conditions 

and list of all necessary medications. 

Use generic names instead of brand 

names. Keep all medication available in carry-on baggage. Make 

sure medications are in original, 

labeled packaging. See Travel.State.

Gov–Country Information, choose 

“Destination” and select “Local 

Laws & Special Circumstances.” 

Some medications may be controlled or illegal substances in 

destination country.
SMALL BUSINESS INTERNATIONAL TRAVEL RESOURCE

TRAVEL HEALTH ASSESSMENT

 Travel Planner — Part 2 | 17

Applies

Y/N Concerns

Follow Up

Actions Resource Timeline

2.A.13 Have you asked healthcare provider 

about the possibility of drug interactions between medications to 

prevent malaria and any other travel 

medications or chronic medications?

2.A.14 Are you pregnant? Seek guidance 

from healthcare provider. See 

Traveling When Pregnant.

2.A.15 Do you have a risk of Deep Vein 

Thrombosis? Seek guidance from 

healthcare provider. See 

Deep Vein Thrombosis.

2.A.16 Are you concerned about stress and 

mental health issues? Seek guidance 

from healthcare provider. See

Stress and Mental Health.

2.A.17 Do you have history of mental health 

concerns? Seek guidance from 

qualified healthcare professional 

to discuss ways to minimize issues 

during travel. Discuss with healthcare provider whether you should 

take a supply of medication to 

manage mental issues. Ask if taking 

psychotropic medications will cause 

problems with customs.
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LOCATION PLAN

Location Health and Safety Plan

Complete this form for each work location.

Company Name: ___________________________________________________________________________________

Location: ___________________________________________________________________________________________

In-Country Contact: _________________________________________________________________________________

Keep a copy of each plan with you for reference on site.

As you complete this plan, remember that how close you are to hazards and how long you are exposed, may 

affect your risk of being injured or becoming sick. For example, if you keep a safe distance away from the 

moving parts of machinery, you will be less likely to be injured. Viewing a noisy operation from an inside area 

that separates you from the source of the sound will help protect you against harmful noise.

Questions to ask yourself:

1. What hazards am I most likely to face?

a. __________________________________________________________________________________________

b. __________________________________________________________________________________________

c. __________________________________________________________________________________________

2. What resources—at home or close by—can I use to be safer around these hazards?

a. __________________________________________________________________________________________

b. __________________________________________________________________________________________

c. __________________________________________________________________________________________
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LOCATION PLAN

3. What should I discusss with my employer to protect me from these hazards?

a. Training in how to recognize and avoid specific hazards

b. Training in selecting and using personal protective equipment (PPE)

c. Evacuation plan for home and local contacts to use in case of emergency or for questions about

possible hazards

4. Important contacts, such as country hosts, managers, health and safety personnel, law enforcement agencies,

and healthcare facilities.

Contact: ______________________________________________ Phone: ______________________

Contact: ______________________________________________ Phone: ______________________

Contact: ______________________________________________ Phone: ______________________
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PACKING LIST

Packing List

Consider These Tips:

•	 Do not pack clothes that are bold, showy, political, patriotic, or immodest by local norms.

•	 Use neutral, not loud colors, to keep from standing out in a crowd.

•	 Women should consider bringing a head covering, if it is customary in the area.

Packing Resource:

•	 CDC’s Pack Smart

Packing for Your Job 

1. List of job-related contacts and resources 

 _________________________________________________________________________________________

 _________________________________________________________________________________________

 _________________________________________________________________________________________

 _________________________________________________________________________________________

2. Personal protective equipment (PPE), if necessary 

 _________________________________________________________________________________________

 _________________________________________________________________________________________

 _________________________________________________________________________________________

 _________________________________________________________________________________________

3. Job-specific clothing such as safety shoes, a hard hat, gloves, or eye protection

 _________________________________________________________________________________________

 _________________________________________________________________________________________

 _________________________________________________________________________________________

 _________________________________________________________________________________________
SMALL BUSINESS INTERNATIONAL TRAVEL RESOURCE

PACKING LIST

22 | Travel Planner — Part 2

4. Medium-weight, neutral-colored pants and long-sleeved shirts (for mosquito/insect protection, sun

protection, and some workplace exposures)

 _________________________________________________________________________________________

 _________________________________________________________________________________________

 _________________________________________________________________________________________

 _________________________________________________________________________________________

5. Reflective or light-colored clothing (for better visibility at night) Socks (cotton, cotton blends, breathable

fabrics for warmer climates and wool for colder ones)

 _________________________________________________________________________________________

 _________________________________________________________________________________________

 _________________________________________________________________________________________

 _________________________________________________________________________________________

6. Other:

 _________________________________________________________________________________________

 _________________________________________________________________________________________

 _________________________________________________________________________________________

 _________________________________________________________________________________________

Packing for Your Location

1. Hotel security list

 _________________________________________________________________________________________
SMALL BUSINESS INTERNATIONAL TRAVEL RESOURCE

PACKING LIST

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2. Season-appropriate outerwear 

 _________________________________________________________________________________________

 _________________________________________________________________________________________

 _________________________________________________________________________________________

 _________________________________________________________________________________________

3. Seasonal hat 

 _________________________________________________________________________________________

4. Rain gear, if necessary

 _________________________________________________________________________________________

 _________________________________________________________________________________________

 _________________________________________________________________________________________

 _________________________________________________________________________________________

5. Insect repellent, if necessary

 _________________________________________________________________________________________

6. Sun screen, if necessary

 _________________________________________________________________________________________

7. Other:

 _________________________________________________________________________________________

 _________________________________________________________________________________________

 _________________________________________________________________________________________

 _________________________________________________________________________________________
SMALL BUSINESS INTERNATIONAL TRAVEL RESOURCE

PACKING LIST

24 | Travel Planner — Part 2

Packing for Your Personal Needs

1. Multiple forms of payment, including credit cards, traveler’s checks, and $200 to $300 cash

 _________________________________________________________________________________________

 _________________________________________________________________________________________

 _________________________________________________________________________________________

 _________________________________________________________________________________________

2. Medications in original containers with labels, if necessary, and a copy of eyeglass prescription

 _________________________________________________________________________________________

 _________________________________________________________________________________________

 _________________________________________________________________________________________

 _________________________________________________________________________________________

3. Health summary or doctor’s letter on official letterhead, if necessary

 _________________________________________________________________________________________

4. Travel health kit, go to CDC Smart Pack

 _________________________________________________________________________________________

5. Copy of passport with minimum two blank VISA pages

 _________________________________________________________________________________________

6. List of personal and emergency contacts

 _________________________________________________________________________________________
SMALL BUSINESS INTERNATIONAL TRAVEL RESOURCE

PACKING LIST

 Travel Planner — Part 2 | 25

7. Healthy, nonperishable snacks

 _________________________________________________________________________________________

 _________________________________________________________________________________________

 _________________________________________________________________________________________

 _________________________________________________________________________________________

8. Other:

 _________________________________________________________________________________________

 _________________________________________________________________________________________

 _________________________________________________________________________________________

 _________________________________________________________________________________________
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CONTACT AND EMERGENCY INFORMATION

Contact and Emergency Information Form

Employer Emergency Contact

Phone: _______________________________________

Country Host

Phone: _______________________________________

Immediate Supervisor On-site

Phone: _______________________________________

Law Enforcement Agency

Address: _____________________________________

Phone: _______________________________________

Health Insurance Company

Policy Number: _______________________________

Phone: _______________________________________

Car Insurance Agency

Policy Number: _______________________________

Phone: _______________________________________

Embassy 

Address: _____________________________________

Phone: _______________________________________

On-site Person of Contact

Phone: _______________________________________

Home Office Contacts

Name: _______________________________________

Phone: _______________________________________

Legal Advisor (Personal)

Phone: _______________________________________

Physician: ____________________________________

Phone: _______________________________________

Local Hospital 

Address: _____________________________________

Phone: _______________________________________

Credit Cards

Card Holder: _________________________________

Number: _____________________________________

Phone: _______________________________________

Card Holder: _________________________________

Number: _____________________________________

Phone: _______________________________________

Card Holder: _________________________________

Number: _____________________________________

Phone: _______________________________________
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INCIDENT REPORT

Incident Report

Your full name: ______________________________________________________________________________________

Position/title: _______________________________________________________________________________________

Phone number: _____________________________________________________________________________________

Email address: ______________________________________________________________________________________

Home address: _____________________________________________________________________________________

Purpose of travel: ___________________________________________________________________________________

Incident Description

Nature of the incidence: Illness/Injury/Theft/Other: ______________________________________________________

Urgency of this report: Normal/High Importance: _______________________________________________________

Date and time of incident: ___________________________________________________________________________

Location description of incident: ______________________________________________________________________

List any individuals involved and role (witness/victim) 

Name: _____________________________________________________________________________________________

Role: ______________________________________________________________________________________________

Phone number: _____________________________________________________________________________________

Email address: _____________________________________________________________________________________

Name: _____________________________________________________________________________________________

Role: ______________________________________________________________________________________________

Phone number: _____________________________________________________________________________________

Email address: _____________________________________________________________________________________

Name: _____________________________________________________________________________________________

Role: ______________________________________________________________________________________________

Phone number: _____________________________________________________________________________________

Email address: ______________________________________________________________________________________

Incident Narrative 

Provide a detailed description of the incident: __________________________________________________________

Submit this form with any supporting documents.
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SMALL BUSINESS INTERNATIONAL TRAVEL RESOURCE

POST-TRAVEL REPORT

Post-travel Report

Inform your employer about any of the following work-related incidents that may have 

occurred during travel:

Injuries or illnesses

 No  Yes-Description: ________________________________________________________________

Motor vehicle crashes

 No  Yes-Description: ________________________________________________________________

Security incidents, violence, or crime

 No  Yes-Description: ________________________________________________________________

Legal issues

 No  Yes-Description: ________________________________________________________________

Workplace-specific exposures to chemicals, physical hazards, or infectious diseases

 No  Yes-Description: ________________________________________________________________

Did you travel to unexpected locations that were not included in your pre-travel 

planning? Describe.

____________________________________________________________________________________________________

Was the job what you expected?

____________________________________________________________________________________________________

Did it change over time?

____________________________________________________________________________________________________

Did you have the appropriate personal protective protection (PPE)?

____________________________________________________________________________________________________

What went well and what could be improved?

____________________________________________________________________________________________________
Promoting productive workplaces through 

safety and health research

DHHS (NIOSH) Publication No. 2019-165

DOI: https://doi.org/10.26616/NIOSHPUB2019165