Get the free Injury Data Collection Form for Supervisors

NC Office of State Human ResourcesInjury Data Collection Form for Supervisors Revised January 1, 2020Instructions: Injured employees' supervisor immediately completes form following work related injury

How to fill out injury data collection form

How to fill out injury data collection form

1. Start by opening the injury data collection form.
2. Enter the date of the injury in the designated field.
3. Provide details about the injured person, including their name, age, and contact information.
4. Specify the location where the injury occurred.
5. Describe the nature of the injury and how it happened in as much detail as possible.
6. If there were any witnesses, note their names and contact information.
7. Include information about any medical treatment the injured person received.
8. Indicate whether the injury resulted in any time off work or lost wages.
9. Provide any additional relevant information or comments.
10. Finally, review the form for accuracy and completeness before submitting it.

Who needs injury data collection form?

1. Anyone who is responsible for collecting data on injuries, such as employers, safety officers, or healthcare professionals, may need an injury data collection form. This form allows them to gather important information about the injury, which can be used for analysis, reporting, or further investigation purposes.

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What is injury data collection form?

The injury data collection form is a document used to gather information about workplace injuries and illnesses.

Who is required to file injury data collection form?

All employers who are covered by OSHA regulations are required to file injury data collection form.

How to fill out injury data collection form?

The injury data collection form can be filled out by entering relevant information about each workplace injury or illness, including the date of incident, type of injury, and whether the employee received medical treatment.

What is the purpose of injury data collection form?

The purpose of the injury data collection form is to help employers track and analyze workplace injuries and illnesses, identify trends, and implement measures to improve workplace safety.

What information must be reported on injury data collection form?

Information such as the date of incident, type of injury, body part affected, and whether the employee received medical treatment must be reported on the injury data collection form.