Employee Accident Incident Report

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How to draft a Employee Accident Incident Report? Download this Employee Accident Incident Report template now!

We support you and your company by providing this Employee Accident Incident Report HR template, which will help you to make a perfect one! This will save you or your HR department time, cost and efforts and help you to reach the next level of success in your work and business!

This Employee Accident Incident Report has ways to grab your reader’s attention. They are crafted by HR professionals, are intelligently structured and easy-to-navigate. Pay close attention to the most downloaded HR templates that fit your needs.     

Download this Human Resources Employee Accident Incident Report template now!

Name of Person Involved: Address: City: Phone Number: Age: DOB: Sex: M F SS : Date of Incident: Time: am/pm Exact Location of Incident: Check Type of Accident: Check: Clerical/Data Entry Patient Communications Employee Testing Process Visitor Result reporting Volunteer Safety Other Medical Device Failure Policy/Procedural Violations Adverse Drug Reaction Vehicle Accident Needlestick Exposure to Hazardous Substance Medication Error (Wrong: Route, Dosage, Medication, Schedule) EMPLOYEE: Involved yes no Were they doing their regular job duties: yes no Observed by employee yes Hire Date: Marital Status: Situation observed only by employee yes Employee Classification: Protective Equipment being used: yes no If not used, Why: Description of Incident/Complaint (Who, What, Where, How, Why, Include sequence of events, personnel involved, body part injured, reason incident occurred) (If medication error include brand name, manufacturer, dosage) (Use additional form if necessary)


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