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Student Injury Report PRIVILEGED AND CONFIDENTIAL This form is to be used only when access to Synergy is not available to the person reporting the injury. See Synergy Student Injury Reporting at https://district.sfusd.edu/dept/risk/default.aspx
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How to fill out student injury report

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How to fill out a student injury report:

01
Provide basic information: Start by filling out the necessary information about the student such as their name, grade level, and contact details. This will ensure accurate identification and communication.
02
Describe the incident: Clearly explain the details of the injury incident, including the date, time, and location. Be specific about what happened, how it occurred, and any contributing factors. It is important to provide a factual account of the incident.
03
Document injuries: Carefully document the student's injuries by describing them in detail. Include information about the affected body parts, any visible wounds, and the severity of the injuries. This will help in assessing the seriousness of the incident and providing appropriate care.
04
Witness statements: If there were any witnesses present during the incident, their statements should be included in the report. Record their names, contact information, and their account of what they saw or heard. This can provide additional perspectives and support the accuracy of the report.
05
Report any immediate actions taken: If any immediate actions were taken to assist the injured student, such as providing first aid or contacting emergency services, make sure to include this information in the report. These actions demonstrate the prompt response to the incident and the care given to the student.
06
Additional information: If there are any other relevant details that could be useful in understanding the circumstances surrounding the incident, include them in the report. This could include any previous injuries or medical conditions that may have contributed to the incident.

Who needs a student injury report?

01
School administration: The school administration needs the student injury report to be informed about any incidents that occur within the school premises. This allows them to take necessary measures to prevent similar incidents in the future and ensure the safety of the students.
02
Parents or guardians: The parents or guardians of the injured student need the injury report to be aware of what happened to their child and to stay informed about the incident. It helps them understand the details of the injury, the actions taken, and the necessary steps for the student's recovery.
03
Healthcare professionals: In case further medical attention is required, healthcare professionals will need the student injury report to understand the nature of the injury, assess the severity, and determine the appropriate treatment. The report can provide crucial information for their evaluation and care plan.
04
Legal purposes: Depending on the circumstances, the student injury report may be required for legal purposes. These could include insurance claims, investigations, or any potential legal actions related to the injury incident. The report serves as an official document to support such proceedings.
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Student injury report is a document used to report any injuries sustained by students while on school premises or during school activities.
School administrators, teachers, or staff members who witness or are made aware of a student injury are required to file a student injury report.
To fill out a student injury report, required information such as student's name, age, date and time of injury, description of injury, and names of witnesses must be provided.
The purpose of a student injury report is to document details of any injuries sustained by students, aid in providing appropriate medical treatment, and track trends to prevent future injuries.
Information such as student's name, age, date and time of injury, description of injury, names of witnesses, and any actions taken post-injury must be reported on the student injury report.
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