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Supervisor\'s Report of Injury or Illness CALL Pi) RN IA ATO BE COMPLETED by SUPERVISOR, NOT EMPLOYEE! 1. Name of2. Name employer:3.of supervisor:Department:CITY of SAN GABRIEL 3. Employee\' s name:4.

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How to fill out pinsupervisors report of injury

01

To fill out the pinsupervisors report of injury, follow these steps:

02

Begin by writing down the date and time of the incident.

03

Provide the name and job position of the injured employee.

04

Include a detailed description of how the injury occurred.

05

Document any witnesses present at the time of the incident.

06

Record the type of injury sustained and its severity.

07

Note any immediate actions taken to provide first aid or medical assistance.

08

Specify any equipment or machinery involved in the incident.

09

Mention the location of the incident.

10

Provide the contact information of the injured employee.

11

Finally, sign and date the report as the supervisor responsible for filling it out.

Who needs pinsupervisors report of injury?

01

The pinsupervisors report of injury is required for any employer or supervisor who has an employee that sustains a work-related injury.

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What is pinsupervisors report of injury?

The pinsupervisors report of injury is a form that must be filled out by supervisors to report any injuries that occur in the workplace.

Who is required to file pinsupervisors report of injury?

Supervisors or managers are required to file the pinsupervisors report of injury.

How to fill out pinsupervisors report of injury?

The pinsupervisors report of injury form typically requires information such as the date and time of the injury, the details of the injury, and the names of any witnesses.

What is the purpose of pinsupervisors report of injury?

The purpose of the pinsupervisors report of injury is to document and track workplace injuries for safety and liability purposes.

What information must be reported on pinsupervisors report of injury?

The pinsupervisors report of injury must include details of the injury, any treatment provided, and the circumstances surrounding the injury.

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