Work-Related Accident/Incident Reporting for Employees

Non-emergency: Contact Human Resources before seeking medical treatment.

1. The Employee and their Supervisor to complete the Work-Related Accident/Incident & Investigation Report (2 pages) and submit it to Human Resources. Page 1 within 24 hours.
2. The Department Head or Supervisor should inspect the site of the accident, complete (page 2) and submit it to Human Resources within 72 hours. Note: Completing page 2 within 24 hours when the employee brings page 1 for the supervisor to sign seems to work best. 
3. It is important that all parts of the forms be completed for insurance and regulatory reporting accuracy.  Human Resources also sends a copy of the report to Risk & Safety Management when received.
4. Link to Form.