Ocjp 920 suspicious injury report form 2026

See details

4.6 out of 5

43 votes

The document is a California Emergency Management Agency form for reporting suspicious injuries, intended for law enforcement use only. It outlines the requirements for health practitioners to report suspicious injuries under Penal Code Section 11160, including patient information, details of the injury, and the reporting process. The form emphasizes confidentiality and mandates immediate reporting to local law enforcement.

Here's how it works

01. Edit your ocjp syllabus online

Type text, add images, blackout confidential details, add comments, highlights and more.

02. Sign it in a few clicks

Draw your signature, type it, upload its image, or use your mobile device as a signature pad.

03. Share your form with others

Send suspicious injury report california via email, link, or fax. You can also download it, export it or print it out.

How to use or fill out ocjp 920 suspicious injury report form with our platform

Ease of Setup

DocHub User Ratings on G2

Ease of Use

DocHub User Ratings on G2

Click ‘Get Form’ to open the ocjp 920 suspicious injury report form in the editor.
Begin with Part A: Patient with Suspicious Injury. Fill in the patient's name, birth date, and gender. Ensure accuracy as this information is crucial for identification.
Provide the patient’s residing address and a safe phone number where they can be reached. If applicable, indicate if the patient speaks English or another language.
Document the date and time of the injury, including location details if available. If unknown, check the appropriate box.
In section 9, include any comments from the patient regarding the incident, along with identifying information about any suspects.
Complete Part B by noting which law enforcement agency was notified and provide details of the person receiving the report.
Finally, fill out Part C with your employer's name and contact information, along with your own details as a health practitioner before signing and dating the form.

Start using our platform today to easily complete your ocjp 920 suspicious injury report form online for free!

be ready to get more

Complete this form in 5 minutes or less

Get form

Got questions?

We have answers to the most popular questions from our customers. If you can't find an answer to your question, please contact us.

What is a reportable injury to Cal OSHA?

All employers are required to notify OSHA when an employee is killed on the job or suffers a work-related hospitalization, amputation, or loss of an eye. A fatality must be reported within 8 hours. An in-patient hospitalization, amputation, or eye loss must be reported within 24 hours.

What is considered a Cal OSHA reportable injury?

Employers must report any worker fatality within 8 hours and any amputation, loss of an eye, or hospitalization of a worker within 24 hours.

What is considered a recordable injury in California?

You must record any significant work- related injury or illness that is diagnosed by a physician or other licensed health care professional. You must record any work- related case involving cancer, chronic irreversible disease, a fractured or ed bone, or a punctured eardrum. See CCR title 8, 14300.7.

What is a suspicious injury report?

Penal Code Section 11160 requires that if any health practitioner, within their scope of their employment, provides medical services for a wound or physical injury inflicted as a result of assaultive or abusive conduct, or by means of a firearm, shall make a telephone report immediately or as soon as possible.

What does OSHA consider a reportable injury?

Any work-related injury or illness requiring medical treatment beyond first aid. Any work-related diagnosed case of cancer, chronic irreversible diseases, fractured or ed bones or teeth, and punctured eardrums.

Security and compliance

At DocHub, your data security is our priority. We follow HIPAA, SOC2, GDPR, and other standards, so you can work on your documents with confidence.

Learn more

What defines a reportable injury?

More Definitions of Reportable injury Reportable injury means any injury other than a serious bodily injury which involves, or in all probability will involve, the enforced absence of the injured person from work for a period of 72 hours or more.

Ocjp 920 suspicious injury report form 2026

Here's how it works