Get 55b23

The 55b23 form is essential for recording incidents of injury or illness in the workplace. This guide will walk you through the process of filling out the form online, ensuring you understand each component and how to complete it accurately.

Follow the steps to fill out the 55b23 form effectively.

1. Press the ‘Get Form’ button to access the online version of the 55b23 form in your browser.
2. Enter the name of the individual who has experienced the injury or illness in the designated field.
3. Record the date of the injury or illness using the format (yyyy-mm-dd) in the appropriate section.
4. Input the time of the injury or illness in the format (hh:mm) along with the appropriate a.m./p.m. designation.
5. Provide the occupation of the affected person in the specified field.
6. Fill in the initial reporting date and time using the (yyyy-mm-dd) and (hh:mm) formats, ensuring to select a.m. or p.m.
7. Complete the follow-up report date and time section in a similar format.
8. Enter the initial report sequence number to track the report effectively.
9. If applicable, record any subsequent report sequence number(s).
10. Detail the description of how the injury, exposure, or illness occurred in the provided text box.
11. Outline the signs and symptoms in the field for the nature of the injury, exposure, or illness.
12. Document the treatment given to the individual in the appropriate section.
13. List the names of any witnesses to the incident in the designated fields.
14. Indicate any arrangements made regarding the worker, such as return to work or medical aid.
15. Select ‘Yes’ or ‘No’ regarding whether a worker handout was provided.
16. Note if alternate duty options were discussed by selecting ‘Yes’ or ‘No’.
17. Print the name of the first aid attendant in the space provided.
18. Confirm whether a form was sent with the worker to medical aid using ‘Yes’ or ‘No’.
19. Ensure the first aid attendant and the patient sign the form in the designated areas.
20. Review all entries for accuracy and completeness before finalizing.
21. Save your changes, and choose to download, print, or share the completed form as needed.

Complete your 55b23 form online today to ensure accurate record-keeping.