Get the free Fireworks Injury Survey - Office of the State Fire Marshal

Phone: 7852963401 fax: 7853686559 www.ksfm.ks.gov 700 SW Jackson, Suite 600 Topeka, KS 66603 Doug Jorgenson, Fire Marshal Sam Brownback, Governor Office of The State Fire Marshal FIREWORKS INJURY

How to fill out fireworks injury survey

How to fill out a fireworks injury survey:

1. Start by carefully reading the instructions provided on the survey form. This will ensure that you understand the purpose and requirements of the survey.
2. Begin by providing your personal information, such as your name, contact details, and any relevant identification numbers. This will help in identifying and contacting you if further information is needed.
3. Answer the questions regarding the nature of the fireworks injury. Be as specific and detailed as possible, describing the type of firework involved, the location and time of the incident, and any other relevant details. This will help in understanding the circumstances surrounding the injury.
4. Indicate the severity of the injury by selecting the appropriate option provided on the survey form. This can range from minor burns or bruises to more serious injuries requiring medical attention.
5. Provide details about the medical treatment sought for the fireworks injury. If you received medical attention, include the name of the healthcare facility or provider, the date of treatment, and any relevant information about the treatment received.
6. If you had to miss work or school due to the injury, indicate the number of days or hours missed. This will help in assessing the impact of the injury on your daily life and productivity.
7. If applicable, mention any legal actions or insurance claims made as a result of the fireworks injury. Providing this information can help in understanding the broader implications and consequences of the incident.

Who needs fireworks injury survey:

1. Individuals who have experienced a fireworks-related injury themselves and want to report it for research or statistical purposes may need to fill out a fireworks injury survey. This includes individuals of all ages, from children to adults.
2. Medical professionals, researchers, or organizations conducting studies or collecting data on fireworks-related injuries may require individuals to fill out a fireworks injury survey to gather information and analyze trends.
3. Government agencies or regulatory bodies responsible for monitoring fireworks safety and determining safety guidelines may use fireworks injury surveys to gather data and assess the effectiveness of existing regulations.

Ultimately, anyone who has experienced a fireworks-related injury and wants to contribute to the understanding and prevention of such incidents may need to fill out a fireworks injury survey.

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What is fireworks injury survey?

The fireworks injury survey is a report that documents any injuries caused by fireworks.

Who is required to file fireworks injury survey?

Anyone who has experienced or witnessed a fireworks injury is required to file a fireworks injury survey.

How to fill out fireworks injury survey?

The fireworks injury survey can be filled out online or in person, and should include details about the injury and how it occurred.

What is the purpose of fireworks injury survey?

The purpose of the fireworks injury survey is to track and prevent injuries caused by fireworks, and to promote safety measures.

What information must be reported on fireworks injury survey?

The fireworks injury survey must include details such as the date and location of the injury, the type of fireworks involved, and the extent of the injury.