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Illness/Injury Report Form Completed forms will be collected and kept on file by the supervisor. Worker Name: Today's Date: Person Completing Report: INJURIES: Date and Time of Injury: Details of
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The illness/injury report form is a document used to report any illnesses or injuries that occur in the workplace.
Employers are usually required to file illness/injury report forms when an employee gets sick or injured while on the job.
The form typically requires information about the employee, the nature of the illness or injury, and any medical treatment received.
The purpose of the illness/injury report form is to document workplace illnesses and injuries, track trends, and identify areas for improvement in workplace safety.
Information such as the employee's name, date of illness or injury, description of the illness or injury, and any medical treatment provided should be reported on the form.
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