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Click ‘Get Form’ to open the epinet full form in the editor.
Begin by entering your last name and first name in the designated fields. This personal information is crucial for identifying the report.
Fill in the injury ID and facility ID, which are for office use only, followed by your birthdate.
Document the date and time of the injury, ensuring accuracy for reporting purposes.
Indicate the department where the incident occurred and your home/employing department.
Select your job category from the provided options, ensuring you tick only one box that best describes your role.
Continue filling out sections regarding the nature of the injury, including whether it was caused by a contaminated sharp item and details about its usage.
Complete any additional sections that require descriptions of circumstances leading to the injury and opinions on safety features.
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