Employee Accident and Investigation Report

Item 6 Employee s normal shift, i.e., days, evenings or nights (specify hours) the days the employee is normally off duty.. Item 11 Indicate exactly what the injury is and what body part(s) have been affected (e.g., sprain to right ankle, cut to the left forearm, cuts to knees of both legs).. If the employee loses work time as a direct result of this injury or illness, please contact Time Records (437-4709) to indicate the expected duration of the absence..