Get Ohio University Employee Incident Report 2016-2025

Filling out the Ohio University Employee Incident Report is a critical step in documenting any work-related injuries or incidents. This guide provides clear, step-by-step instructions to help users complete the form accurately and efficiently.

Follow the steps to complete the employee incident report online.

1. Click ‘Get Form’ button to access the Employee Incident Report and open it in the editing interface.
2. Select the appropriate category for the employee by checking one of the boxes: Classified, Administrative, Bargaining, Faculty, Student Employee, or Other. If selecting 'Other', provide a brief description.
3. Enter the full name of the employee in the designated field.
4. Input the employee's identification number.
5. Fill in the employee's date of birth.
6. Provide the employee's gender in the relevant field.
7. Complete the mailing address of the employee.
8. Specify the city where the employee resides.
9. Fill in the state of residence.
10. Input the zip code for the mailing address.
11. Provide the home telephone number of the employee.
12. Enter the campus phone number.
13. Indicate the department to which the employee belongs.
14. Fill in the building, area, or shop where the employee works.
15. Input the employee's hire date.
16. Specify the job title of the employee.
17. Enter the date when the incident occurred.
18. Specify the time of the incident using AM/PM options.
19. Provide the time the employee started work, also using AM/PM options.
20. List the full names and phone numbers of any witnesses present during the incident.
21. Describe what the individual was doing and where just before the incident, including details of any tools, equipment, or materials being used.
22. Explain how the injury occurred, detailing any unsafe conditions or violations of safety rules.
23. Specify the injury or illness, being precise about the affected body part.
24. Indicate what object or substance caused the injury.
25. Provide the name of the health care provider associated with this incident.
26. Indicate whether the employee was performing regular job duties at the time of the incident.
27. State whether the employee was trained for the specific job or activity involved in the incident.
28. List any actions taken or planned to prevent similar incidents in the future.
29. Note any pre-existing injuries or conditions that may have contributed to the incident.
30. Enter the date that the injury was reported to the supervisor.
31. Document the date when the incident was investigated.
32. Indicate if the employee was wearing slip-resistant shoes at the time of the incident.
33. State whether the employee was using proper personal protective equipment.
34. Fill in the name of the manager on duty at the time of the injury.
35. Print the supervisor's name in the designated field.
36. Provide the supervisor's email address.
37. Obtain the signature of the injured person.
38. Enter the phone number of the injured person.
39. Specify the date the report was completed.
40. Acquire the signature of the supervisor.
41. Once all sections are completed, save your changes. You can also download, print, or share the form as needed.

Complete the Ohio University Employee Incident Report online to ensure accurate documentation of work-related incidents.