Injury incident report template pdf

The doctor will need this to assess the patient and the incident, so that they can do a proper diagnosis, prepare a proper treatment plan and provide an appropriate prognosis. If personnel were injured during the incident, do not use this form, use supervisors injuryillness report. Employees shall use this form to report all work related injuries, illnesses, or near miss events which could have caused an injury or illness no matter how minor. Use this form to report accidents, injuries, medical situations, or student behavior incidents. It is an important document that is used in order to report any mishap or accident that has occurred in the workplace. Noninjury and nearmiss incident reporting form instructions. Actual event incident a situation that did occur either with or without harm or injury to the individuals. Free injury incident report form template pdf word. The victim here could either be an employee, client, vendor or just about anyone visiting the office.

Prevent incidents from happening again by properly recording and documenting them with this free injury incident report form template. Incident reporting to record accidents and injuries in the workplace. Sample form for your own use not for reporting to worksafe. This incident form template can typically be used to document an auto. Injuryincident report form mcmaster hr mcmaster university. This helps us to identify and correct hazards before they cause serious injuries. An incident report form is maintained and addressed by the hr department of every company. Incidents involving a crime or traffic incident should be reported. Automatically save pdf reports online to the cloud. This form will be submitted to the mtf patient safety manager, risk manager, or other responsible individual iaw local policy, nlt 48 hours after the event. Osha form 301 injury and illness incident report the evergreen.