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Instructions: This form supplements the Injury, Illness, Incident Data Form and is for the collection and reporting of data associated with a work related, injury, illness or incidents involving employees,
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This form supplements the instructions provided for another form.
Those individuals or entities who are completing the related form may be required to refer to these instructions as well.
Follow the detailed guidelines and explanations provided in the instructions to properly fill out the related form.
The purpose is to provide additional information, clarification, and guidance for the completion of the related form.
Specific information relevant to the completion of the related form may be required to be reported in these instructions.
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