Accident injury 2025

1. Click ‘Get Form’ to open the Accident/Injury Report in the editor.
2. Begin by entering the name of the injured employee, their ID number, department, and job title. Indicate whether they are a regular or temporary employee.
3. Fill in the injury date and time, specifying AM or PM. Record the date reported and the last day worked. If no time was lost, simply write 'same'.
4. Provide details about the supervisor and who reported the incident. List any witnesses present during the accident.
5. Describe where the injury occurred, including specific location and building information if applicable.
6. In the 'WHAT HAPPENED' section, detail what the employee was doing at the time of the accident and how it occurred. Indicate if equipment malfunctioned and explain any unsafe acts or conditions that contributed to the incident.
7. For medical information, describe the nature of the injury (e.g., cut, strain). State whether medical services were provided and list all relevant medical personnel consulted.
8. If additional space is needed for explanations or details, attach an extra sheet as necessary.

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