Get the free NON-EMPLOYEE INJURY FORM - the Diocese of Worcester - worcesterdiocese

NON-EMPLOYEE INJURY FORM NAME: DATE: TIME: DIOCESE PROPERTY OF ACCIDENT: ADDRESS: PHONE: CONTACT PERSON: WITNESS: NATURE OF INJURY: WEATHER CONDITIONS: (if applicable) MEDICAL ATTENTION SOUGHT: EXPLAIN

How to fill out non-employee injury form

How to fill out a non-employee injury form:

1. Obtain the form: The first step is to obtain the non-employee injury form. This form is typically available from the human resources or the safety department of the company that the injured person was visiting or working with at the time of the incident.
2. Provide accurate information: The form will require you to fill in various fields with accurate information related to the incident. Make sure to provide details such as the date and time of the accident, the location, and a brief description of what happened.
3. Identify the injured person: Clearly state the name, address, and contact details of the injured person. This information will be important for any follow-up contact or correspondence related to the incident.
4. Describe injuries sustained: In this section, provide specific details about the injuries sustained by the non-employee. Describe any physical injuries, pain experienced, or medical treatment received as a result of the incident.
5. Include witness statements: If there were any witnesses to the incident, their statements can be crucial. Include the names and contact details of any witnesses and encourage them to provide a written account of what they saw.
6. Attach relevant documents: If there are any medical reports, photographs, or other supporting documentation related to the incident, make sure to attach them to the form. This will provide a more comprehensive picture of the situation.
7. Submit the form: Once you have completed all the necessary sections of the form and attached any relevant documents, it is time to submit it. Follow the instructions provided on the form to ensure that it reaches the appropriate department within the specified timeframe.

Who needs a non-employee injury form?

A non-employee injury form is typically required in situations where someone who is not an employee of a company sustains an injury while on the company's premises or under its supervision. This may include contractors, visitors, or customers who are injured due to an accident or incident that occurs in connection with the company's activities.

The purpose of the form is to document the details of the incident and provide a clear record of the non-employee's injuries. It allows the company to investigate the incident, assess potential liability, and take appropriate actions to prevent similar incidents in the future. It also helps in managing any potential insurance claims or legal proceedings that may arise as a result of the injury.

For pdfFiller’s FAQs

What is non-employee injury form?

Non-employee injury form is a document used to report injuries or accidents involving individuals who are not employees of a company, such as visitors or contractors.

Who is required to file non-employee injury form?

Anyone who is aware of a non-employee injury or accident is required to file the non-employee injury form, including supervisors, managers, and HR personnel.

How to fill out non-employee injury form?

To fill out the non-employee injury form, one must provide details about the injury or accident, including the date, time, location, and a description of what occurred. Contact information for the injured party should also be included.

What is the purpose of non-employee injury form?

The purpose of the non-employee injury form is to document and report any injuries or accidents involving individuals who are not employees, in order to ensure proper care and follow-up.

What information must be reported on non-employee injury form?

The information that must be reported on the non-employee injury form includes details about the injury or accident, such as the date, time, location, and a description of what occurred. Contact information for the injured party should also be provided.

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