Accident/Injury Report Form

Instructions: Employees/Witnesses 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. This helps us to identify and correct hazards before they cause serious injuries. This form shall be completed by employees as soon as possible and given to your supervisor and HR/Safety for further action.

*You MUST let HR/Safety know if you have had a work-related incident that requires medical attention.

Incident Report - Non-Medical

*If this is a work-related accident/incident then you need the Accident/Incident Report Form*

Instructions: Employees shall use this form to report all non-medical incidents. This helps us to identify and correct hazards before they cause serious incidents and injuries. This form shall be completed by employees as soon as possible and given to your supervisor and HR/Safety for further action.


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