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HARRISBURG SCHOOL DISTRICT Office of Human Resources 2101 North Front Street, Building 2 Harrisburg, PA 17110 (717) 7034006 FAX (717) 7034117 www.hbgsd.k12.pa.us CORRELATED INCIDENT REPORT Injured
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How to fill out work-related incident report
How to fill out a work-related incident report:
01
Begin by gathering all relevant information about the incident, such as the date, time, and location of the incident, as well as names and contact information of any witnesses.
02
Describe the incident in detail, including what happened, how it happened, and any contributing factors. Be objective and stick to the facts.
03
Document any injuries or damages that occurred as a result of the incident. If there were any medical treatments provided, make sure to include those details as well.
04
Identify any potential hazards or unsafe conditions that may have contributed to the incident. This could include faulty equipment, inadequate training, or any other factors that need to be addressed for future prevention.
05
List any immediate actions taken to address the incident, such as first aid administered, contacting emergency services, or notifying a supervisor.
06
Provide your contact information and signature at the end of the report.
07
Submit the completed incident report to the appropriate party, such as your supervisor, human resources department, or safety officer.
Who needs a work-related incident report:
01
Employers: Work-related incident reports are essential for employers to track and investigate workplace accidents, identify any patterns or trends, and take corrective actions to prevent future incidents.
02
Employees: It is important for employees to fill out work-related incident reports as it helps to document the incident accurately and ensure that appropriate actions are taken to address any injuries or damages.
03
Insurance companies: Work-related incident reports are often required by insurance companies to process claims related to workplace accidents and injuries.
04
Regulatory authorities: Some industry-specific regulatory authorities may require work-related incident reports to ensure compliance with safety regulations and standards.
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What is work-related incident report?
Work-related incident report is a document that details any accidents, injuries, or near misses that occur in the workplace.
Who is required to file work-related incident report?
Employers are required to file work-related incident reports.
How to fill out work-related incident report?
Work-related incident reports can typically be filled out online or using a specific form provided by the employer.
What is the purpose of work-related incident report?
The purpose of work-related incident report is to document and investigate workplace incidents to prevent future occurrences.
What information must be reported on work-related incident report?
Information such as date, time, location, nature of incident, individuals involved, and witnesses must be reported on work-related incident report.
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