BLOODBORNE PATHOGEN INCIDENT (ACCIDENT) REPORT 2025

1. Click ‘Get Form’ to open the BLOODBORNE PATHOGEN INCIDENT (ACCIDENT) REPORT in the editor.
2. Begin by entering the employee's name in the designated field. This is crucial for identifying who reported the incident.
3. Next, input the immediate supervisor's name to ensure proper oversight and accountability.
4. Fill in the date of the incident and the time it occurred. Accurate timestamps are essential for record-keeping.
5. Describe the incident location and case number if applicable. This helps in tracking and referencing specific incidents.
6. Provide a detailed account of the incident, including exposure routes, circumstances, controls in place, and any unsafe conditions observed.
7. Document any injuries sustained by the employee, specifying which part of the body was affected.
8. Record details about first aid or medical treatment provided, including who administered it and when.
9. Indicate when and to whom the incident was reported. If there was a delay, explain why.
10. List names of witnesses who observed the incident to support your report.
11. If known, provide information about the source individual and whether consent for blood testing was obtained.
12. Outline any corrective actions taken or planned to prevent future incidents from occurring.
13. Finally, confirm if a referral to a medical evaluator was made and provide an explanation if not.

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