Public pool and spa injury incident report form - Toledo Lucas ... 2026

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The document is a Public Pool and Spa Injury Incident Report Form designed for local health districts. It outlines the procedures for reporting injuries, drownings, or near-drownings at pool or spa facilities. The form requires details about the incident, the injured person, and facility information while ensuring no personal information is included. Reports must be submitted within specified timeframes depending on the severity of the incident.

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Click ‘Get Form’ to open it in the editor.
Begin by filling out the 'Facility Information' section. Enter the facility name, address, city, state, type, and phone number. Ensure all details are accurate for proper reporting.
In the 'Description of Injured Person' section, provide information such as age, sex, race (without personal identifiers), and resident county.
Next, detail the 'Description of Incident'. Include the incident date and time, a brief description of what happened, and whether the pool/spa was open at that time.
Indicate if any rescues or medical interventions were required. Check all applicable boxes regarding lifeguard presence and care provided.
Complete the 'Description of Injury' section by selecting the type of injury sustained and specifying the area injured.
Finally, ensure that a pool operator reviews and completes their information before submitting the form to your local health district.

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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.

Who regulates pools in Ohio?

Public swimming pools, spas and special use pools are regulated under the authority of Chapter 3749 of the Ohio Revised Code (ORC) and Chapter 3701-31 of the Ohio Administrative Code (OAC).

How do I report an accident in Ohio?

If you are injured or have damages, call 911. Otherwise, report your accident to local law enforcement or the Ohio State Highway Patrol. You also can complete an Uninsured Accident Report.

How long after a car accident can you file a police report in Ohio?

When You Should Report an Accident to the Police. In addition to the above conditions per Ohio Revised Code Section 5502.11, if you are reporting a collision with an uninsured driver, you have six months from the date of the accident to report it.

Can I make an accident report online in Toledo, Ohio?

*ONLINE REPORTS: Certain police reports can be filed online, see below for details. Accident reports can not be filed online.

Can I file a police report online in Toledo, Ohio?

The Citizen Online Police Reporting System can be used to file basic police reports when all of the following criteria are met: Does not involve use or theft of a debit or credit card. No known suspects. No physical evidence.

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