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How to use or fill out HOPE COLLEGE ACCIDENT INJURY REPORT FORM Case with DocHub
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Click ‘Get Form’ to open the HOPE COLLEGE ACCIDENT INJURY REPORT FORM in our editor.
Begin by filling out the 'Personnel Information' section. Enter your name, date of birth, occupation, address, home phone number, marital status, role (Faculty/Staff/Student), department, and supervisor's contact information.
Next, move to the 'Incident Information' section. Input the date and time of the incident, your work status (Full Time, Part Time, Pool), and the location where the incident occurred. Describe what you were doing before the incident and how it happened.
Detail the affected body part and how it was impacted. Identify any object or substance that caused the injury and mention any contributing factors to the incident.
In 'Injury Lost Time Information', indicate if you will lose time from work due to this incident and specify any dates if applicable. Also note if you will be on restricted or light duty.
Check all applicable types of incidents in the provided list and complete any additional comments as necessary.
For 'Medical Action', select all relevant options regarding medical treatment received or planned. If admitted to a hospital, provide its details.
Complete supplemental information including when your supervisor was informed and your email address. Finally, print a copy for your records before submitting via email to reilly@hope.edu.
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A member of the Michigan Intercollegiate Athletic Association (MIAA) and National Collegiate Athletic Association (NCAA) Division III, Hope sponsors 22 varsity sports for men and women.
What famous people went to Hope College?
Notable alumni of Hope College include: Betsy Aardsma, unsolved victim. Tom Andrews, poet and critic. Jeff Bates, co-founder of Slashdot. Kathy Beauregard, former director of athletics for Western Michigan University. James Bosman, New Hampshire politician. Rychard Bouwens, associate professor at Leiden University.
How do I contact Hope College?
You can also contact us by phone at 616.395. 7883 MondayFriday from 8 a.m.4 p.m.
Is Hope College conservative?
It is not necessary to be a conservative Christian to appreciate Hope College, but students are assured of an environment where controversial social issues will be discussed openly in realistic ways that maintain fidelity with traditional Christian positions.
How do I contact a College?
Admissions officers usually provide their contact information via the admissions website because they want to be accessible and available to answer questions from applicantseither about the college application process or about the school.
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Hope College is ranked #90 out of 211 National Liberal Arts Colleges. Schools are ranked according to their performance across a set of widely accepted indicators of excellence.
What is the Hope College policy on non discrimination?
It is the policy of Hope College not to discriminate on the basis of age, disability, ethnicity, familial status, genetic information, height, national origin, race, religion (except in the event of a bona fide occupational qualification), sex (including gender expression, gender identity, pregnancy, sexual orientation
Related links
Hope College Accident Injury Report Form
Form must be completed within 24 hours of incident. Questions? Call Occupational Safety Office. X7999 or Human Resources X7811. Personnel Information. Employee
MO500-3311 Report of Accident, Injury and/or Emergency
REPORT OF ACCIDENT, INJURY, AND/OR EMERGENCY MEDICAL CARE FACILITY DATETIMECHILDS NAME STAFF MEMBER RESPONSIBLE FOR CHILD AT TIME OF INCIDENT PERSON IN CHARGE
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