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Report of Injury or Death to Peace OfficerAgency/Facility Informational Received: 7/27/2022 Date Uploaded: 7/27/2022Date of Report: 7/27/2022Amended Date:Version Type: ORIGINALName of Agency/Facility:San
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01
Gather all relevant information about the injured person.
02
Visit the agency or facility's website to find the necessary forms or contact information.
03
Fill out the forms provided, making sure to include all required information about the injured person.
04
Submit the completed forms to the agency or facility either in person, by mail, or electronically.

Who needs agencyfacility information injured or?

01
Anyone who has been injured and is seeking medical treatment or assistance from a specific agency or facility.
02
Family members or caregivers of the injured person who need to provide information on their behalf.
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The agency/facility information injured or is a form that provides details about the agency or facility where the injury occurred.
The person responsible for reporting workplace injuries must file the agency/facility information injured or.
The agency/facility information injured or form can be filled out by providing accurate details about the agency or facility where the injury occurred.
The purpose of the agency/facility information injured or form is to track and record workplace injuries at specific agencies or facilities.
The agency/facility information injured or form must include details such as the name of the agency or facility, the date and time of the injury, and a brief description of what happened.
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