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PEOPLES PLACE EMPLOYEE INCIDENT×INJURY REPORT FORM NAME OF EMPLOYEE ADDRESS (INCLUDE COUNTY) TELEPHONE NUMBER OF EMPLOYEE: HOURS WORKED PER WEEK: PROGRAM: NORMAL STARTING TIME: DATE AND TIME OF INCIDENT:
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How to fill out peoples place employee incidentinjury
How to fill out a People's Place employee incident/injury form:
01
Start by writing your personal information at the top of the form, including your name, employee ID, job title, and contact details.
02
Provide the date and time of the incident/injury in the designated fields. Be as accurate as possible.
03
Describe the location of the incident/injury, including the department or area within the workplace.
04
Explain the circumstances surrounding the incident/injury. Provide a detailed account of what happened, including any factors or conditions that may have contributed to the incident.
05
If there were any witnesses present, their names and contact information should be recorded on the form.
06
Describe the nature of the injury or incident. Include a description of any injuries sustained, such as cuts, bruises, strains, or sprains.
07
Indicate whether medical treatment was required or provided. If you sought medical attention, include the name of the healthcare provider and any treatments received.
08
Provide details of any equipment, machinery, or tools involved in the incident. Include the make, model, and serial number if available.
09
If there was property damage during the incident, describe the extent and the value of the damaged items.
10
Finally, sign and date the form to confirm the accuracy of the provided information.
Who needs a People's Place employee incident/injury form?
01
Employees who have experienced an incident or injury while at work are required to fill out the form.
02
Supervisors, managers, or safety officers may also need to complete the form if they are involved or have knowledge of the incident.
03
The HR department or the company's safety team will usually need this form to ensure proper documentation of incidents and injuries in the workplace.
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