Get Ohio University Employee Incident Report 2016-2025

Completing the Ohio University Employee Incident Report is essential for documenting work-related injuries, illnesses, or incidents. This guide will help you navigate the form online with step-by-step instructions tailored to ensure all necessary information is properly recorded.

Follow the steps to accurately complete the report online.

1. Click 'Get Form' button to obtain the form and open it for completion.
2. Begin by selecting the appropriate category for your employment status from the options provided, such as classified, administrative, or faculty.
3. Fill in your personal information accurately, including your name, employee number, date of birth, and mailing address.
4. Provide your contact details, including your home phone and campus phone, as well as your department name.
5. Indicate the building, area, or shop where you work, along with the date you were hired and your job title.
6. Record the date and time when the incident occurred, specifying whether it was in the AM or PM.
7. List the full name and contact number of any witnesses to the incident.
8. Detail what you were doing and where just before the incident, including any tools or materials you were using.
9. Describe the incident itself, explaining how the injury occurred and noting any unsafe conditions or safety rule violations.
10. Specify the nature of the injury or illness, clearly indicating the affected body part and the specifics of the injury.
11. If applicable, identify the object or substance that directly caused the injury.
12. Provide the name of the healthcare provider you consulted for this incident and the date of your visit.
13. Indicate whether you were performing regular job duties at the time of the incident.
14. State if you received training for the specific job or activity involved in the incident, including the date of training if applicable.
15. Outline any corrective actions or measures that will be implemented to prevent a recurrence of the incident.
16. Answer whether there was any pre-existing injury or condition that could have contributed to the incident.
17. Record the date when the injury was reported to your supervisor and when the investigation took place.
18. If the incident resulted in death, please indicate this and provide the corresponding date.
19. The supervisor must print their name, phone number, and email address, and provide their signature.
20. After completing, ensure the report is signed by both the injured individual and the supervisor.
21. Finally, save your changes, and make sure to download or print a copy for your records. You may also share the completed form as necessary.

Get started on completing your Employee Incident Report online today.