Employee Injury Report Form. __male __female date of birth: If an injury occurs to someone in the workplace, one of the first things to do after seeking any required medical or emergency personnel is to fill out an employee injury report form.
Free Printable Injury Form Templates (Word PDF)
This helps us to identify and correct hazards before they cause serious injuries. Department of labor (see instructions on reverse) office of workers' compensation programs omb no. Web an employee incident report is a report used to document an accident, injury, exposure to a hazardous substance, or another incident that occurs at work or at a workplace. If an injury occurs to someone in the workplace, one of the first things to do after seeking any required medical or emergency personnel is to fill out an employee injury report form. This form shall be completed by employees as soon as possible and given to. Learn details and how to report online or by phone Word | pdf | smartsheet. Other examples of incidents include violent behavior, theft, and any other threat to the safety of people or property. Web employer's first report of injury. Web get recordkeeping forms 300, 300a, 301, and additional instructions read the full osha recordkeeping regulation (29 cfr 1904) severe injury reporting employers must report any worker fatality within 8 hours and any amputation, loss of an eye, or hospitalization of a worker within 24 hours.
It will need completion to happen on time. Calling your closest area office during normal business hours; Many employers are required to electronically submit information from their form 300a summary to osha. Word | pdf | smartsheet. Web employer's first report of injury. Download workplace incident report form template. Date and time of accident (mm/dd/yyyy) (hh:mm am/pm) 4. If an injury occurs to someone in the workplace, one of the first things to do after seeking any required medical or emergency personnel is to fill out an employee injury report form. This form shall be completed by employees as soon as possible and given to. Web downloadable employee injury report form for timely reporting. Web osha form 301, the injury and illness incident report.
