Notice only 2026

1. Click ‘Get Form’ to open the notice only document in the editor.
2. In Section A, begin by entering the date the incident was reported. Fill in your name, office phone number, job title, and social security number.
3. Next, provide the date and time of the incident. Describe what happened in detail, including how, where, and why it occurred.
4. Indicate the type of incident (e.g., cut, scrape) and specify the place of occurrence. List any witnesses along with their contact numbers.
5. Complete the supervisor's section by entering the date notified of injury and reviewing all facts related to the incident. Document any hazardous conditions or unsafe practices identified.
6. Provide recommendations for preventing future incidents and actions taken to ensure these recommendations are implemented. Finally, sign and date the report.

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