Get Student Accident Report

Filling out the Student Accident Report online is a crucial step in documenting an incident involving a student. This guide will walk you through each section of the form, ensuring you provide all necessary information accurately and efficiently.

Follow the steps to successfully complete the report

1. Click ‘Get Form’ button to obtain the form and open it in the editor.
2. Begin by entering the today's date in the designated field. This is important for record-keeping purposes.
3. Next, input the date and time the injury occurred to provide a precise context regarding the incident.
4. Fill in the student's information, including their name, date of birth, address, CSID, city, state, cell phone number, and home phone number. This ensures the student can be adequately identified.
5. If applicable, note the name of the student’s health insurance plan. This information can be crucial for medical follow-up.
6. Input the details of the emergency contact, including their name and phone number. This contact should be readily available in case of further communication.
7. In the Accident/Injury Summary section, specify the location of the accident and indicate whether first aid was administered, along with the name of the person who provided it.
8. Identify the body parts that were injured during the incident. This information assists in understanding the nature and extent of injuries.
9. Indicate if the student was participating in an intercollegiate event and whether they were transported by ambulance.
10. Describe exactly how the accident happened, providing as much detail as possible to give clarity to the circumstances of the incident.
11. Note the disposition of the student after the accident, such as whether they returned to class, went home, or visited an emergency room.
12. Indicate if a police report was taken and the name of the campus police officer involved, if applicable.
13. Specify whether the HSR Student Accident form was issued to the student, including the date it was issued.
14. If there were any witnesses, record their name and phone number for follow-up.
15. Finally, provide your signature as the person completing the form to verify the accuracy of the information before submitting.
16. Once all fields are filled out, promptly send this completed form to risk management/district office and ensure a copy is sent to the VPA office (Campus Safety Officer).

Complete the Student Accident Report online now for accurate documentation of the incident.