Get Student Injury Claim Form.pdf

Filling out the Student Injury Claim Form accurately is crucial for documenting student accidents and facilitating appropriate follow-up actions. This guide provides a step-by-step process for completing the form online, ensuring you provide all necessary information clearly and comprehensively.

Follow the steps to complete the form successfully

1. Click ‘Get Form’ button to obtain the form and open it in the editor.
2. Begin by entering the date the accident was reported. Fill in the teacher or supervisor's name and indicate the date and time of the accident, specifying whether it occurred in the AM or PM.
3. In the next section, fill out the district name and school name. Provide the principal's name and school phone number for reference.
4. Complete the student's details, including their first name, last name, middle initial, address, phone number, age, date of birth, sex, and grade.
5. Enter the parent's name as well as an alternative phone number for further contact.
6. Indicate the nature of the injury by checking the appropriate box, and specify the place where the accident occurred by selecting the relevant option.
7. List the body part injured by checking the specific area and provide any additional information if necessary.
8. Describe the accident and the injury in as much detail as possible, providing a clear account of the events.
9. Answer the question regarding first aid administration and who provided it, if applicable.
10. Indicate whether the student was sent home, to a physician, or to a hospital following the accident.
11. Confirm if the student's attendance will be affected by checking 'Yes' or 'No'. If 'Yes', note how many days the student will be unable to attend.
12. Finally, sign and date the form where indicated for the person completing the report, principal, and parent.

Complete the necessary documentation online today to ensure timely processing and support.