Non-Employee Incident/ Injury Report - Texas Tech University ... - ttuhsc: Fill out & sign online

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Click ‘Get Form’ to open it in the editor.
Begin by filling out the 'Personal Information' section. Enter your title, full name, date of birth, sex, and status (Student, Visitor, or Volunteer). Provide your home address and contact information.
In the 'Incident / Injury Details' section, specify the date and time of the injury. Describe the injury in detail and explain how the incident occurred. If necessary, use our platform's drawing tools to create a diagram illustrating conditions at the scene.
Indicate which campus the incident occurred on and provide the name/address where the injury took place. Confirm whether medical treatment was required by selecting 'Yes' or 'No'.
Complete the 'Name of Witness / Name of Preparer' section by entering details for witnesses and supervisors involved. Ensure you include signatures where required.
Review all entries for accuracy before submitting your report within 72 hours to the Department of Safety Services.

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