EMPLOYEE INJURY & INCIDENT REPORT - lawrence 2026

1. Click ‘Get Form’ to open it in the editor.
2. Begin by entering your personal information in the designated fields, including your name, department, and job title. Ensure accuracy as this information is crucial for processing your report.
3. Fill in the date and time of the injury, along with your date of birth and contact information. This helps in establishing a timeline and ensuring you can be reached if needed.
4. Specify the location where the injury occurred. Be detailed about the exact site to assist in any follow-up investigations.
5. In the 'INJURY DESCRIPTION' section, indicate the body part(s) affected and type of injury by checking the appropriate boxes. Use the body diagram provided to mark specific areas.
6. Provide a detailed account of what you were doing before the incident and how it happened. This narrative is essential for understanding circumstances surrounding the injury.
7. List any tools or materials involved at the time of injury, previous injuries to that body part, and suggest corrective actions to prevent future incidents.
8. Finally, sign and date the form before submitting it via email or delivering a hard copy within 24 hours as required.

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