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Critical Injury Form Clear Form As per Ontario Regulation 420/21, a critical injury is an injury of a serious nature that: Places life in jeopardy; Produces unconsciousness; Results in a substantial
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How to fill out critical injury form

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How to fill out critical injury form

01
Obtain the critical injury form from the necessary source (employer, HR department, etc.)
02
Fill out personal information accurately including name, contact information, and employee identification.
03
Provide details of the critical injury incident including date, time, location, and description of what happened.
04
Specify any witnesses to the incident and their contact information if available.
05
Sign and date the form to validate the information provided.

Who needs critical injury form?

01
Employees who have experienced a critical injury on the job and are required to report it to their employer or relevant authorities.
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Critical injury form is a document used to report any serious injury or illness that occurs in the workplace.
Employers are required to file critical injury form when a serious injury or illness occurs in the workplace.
Critical injury form must be filled out with details of the injury or illness, including date, time, location, and nature of the incident.
The purpose of critical injury form is to ensure that workplace injuries and illnesses are properly documented and reported for investigation and prevention.
Critical injury form must include details such as the name of the injured worker, date and time of the incident, location, description of the injury or illness, and any contributing factors.
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