TATE OF ORTH CAROLINA OFFICE OF STATE HUMAN RESOURCES 1331-2026

1. Click ‘Get Form’ to open it in the editor.
2. Begin by filling out the NC Employee Incident Report section. Provide your full name, employee ID, job title, and contact information.
3. Document the date and time of the incident, along with the location. Be specific about where the incident occurred.
4. In the 'Description of Accident/Incident' field, clearly outline what happened. Use a step-by-step approach to detail the sequence of events leading up to the incident.
5. If there were witnesses, list their names and contact information in the designated section. This is crucial for gathering additional perspectives on the incident.
6. Complete any medical information required, including parts of the body injured and prior injuries if applicable.
7. Finally, review all entries for accuracy before submitting your report through our platform. Ensure that all necessary fields are filled out completely.

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