Get 35804 Incident Form

Filling out the 35804 Incident Form online is essential for documenting vehicle accidents and incidents in a structured manner. This guide will provide clear, step-by-step instructions to help users navigate each section of the form effectively.

Follow the steps to complete the form accurately.

1. Press the ‘Get Form’ button to access the form and open it in the online editor.
2. In the details section, enter the name of the employer and their designation. Make sure to accurately reflect the employer's department or district.
3. Provide information about the person involved in the incident, including their name, unique number, ID number, occupation, age, and years of service.
4. Indicate the location and date of the accident, along with the time it occurred.
5. Detail the nature and type of injury sustained. Check appropriate boxes to describe if the injuries were fatal, disabling, or required medical attention.
6. Identify any immediate causes of the incident, noting any unsafe equipment or conditions that contributed to the accident.
7. Specify root causes for the incident, including any inadequacies in design, maintenance, or conditions that may have played a role.
8. Complete the corrective action section by detailing how the employer plans to prevent recurrence of similar incidents.
9. Have the designated investigator sign the form and date it, confirming the accuracy of the details provided.
10. Once all sections are complete, save your changes, and consider downloading, printing, or sharing the completed form.

Take the next steps towards effective incident reporting by completing the 35804 Incident Form online today.