Get Supervisor Accident Report Form - Ncssm

Filling out the Supervisor Accident Report Form - Ncssm online is an essential process for documenting workplace incidents effectively. This guide provides step-by-step instructions to ensure you complete the form accurately and comprehensively.

Follow the steps to fill out the Supervisor Accident Report Form correctly.

1. Click ‘Get Form’ button to obtain the Supervisor Accident Report Form - Ncssm and open it for online completion.
2. Enter the file number and the dates relevant to the incident, including the date of the accident and the date reported, in the specified format.
3. Provide the time of day when the accident occurred. Specify whether it was AM or PM.
4. Indicate if the accident occurred on the employer's premises by selecting 'Yes' or 'No'.
5. Fill in the supervisor's name, telephone number, department or university, address, and division to identify the reporting authority.
6. Detail the location of the accident within the facility to provide context for the incident.
7. List the witnesses’ names and their day-time telephone numbers to ensure availability for follow-up.
8. For personal injury incidents, provide the name of the injured person, their social security number, home and work telephone numbers, home address, sex, age, job title, and employment date.
9. Document the employee’s disposition status and any required treatment related to the accident.
10. If property damage occurred, specify the type of damage and provide relevant details such as vehicle identification, major equipment, or private property involved.
11. Describe the accident or incident in detail, focusing on the immediate and basic causes as well as contributing factors.
12. Outline the corrective actions already taken and recommend any future actions to prevent recurrence along with anticipated completion dates.
13. Collect comments from management regarding the appropriateness of the causes and corrective actions outlined.
14. Finalize your report by signing it, including your title, telephone number, and the date.
15. After completing the report, review all entries for accuracy, then save changes, download, print, or share the form as required.

Complete your Supervisor Accident Report Form - Ncssm online today to ensure timely and accurate documentation of workplace incidents.