Get Supervisors Accident Analysis And Prevention Report - Wisconsin

Filling out the Supervisor's Accident Analysis and Prevention Report correctly is essential for documenting workplace incidents in Wisconsin. This guide provides step-by-step instructions to help users complete the form accurately and efficiently online.

Follow the steps to fill out the form effectively.

1. Click ‘Get Form’ button to obtain the report and open it in your preferred online document editor.
2. Begin by entering the employee's name and the department name along with its location in the designated fields.
3. Fill in the date of the accident and the employee’s social security number, ensuring all details are accurate as this information is important for records and processing.
4. Indicate the job classification and work unit of the employee involved in the accident, which helps to categorize the nature of the work performed.
5. Record the time of the accident and the date on which the injury was reported; both are crucial for tracking incidents.
6. In the accident description section, provide a detailed description of how the accident occurred, including specific actions, the location of the accident, and whether safety procedures were followed.
7. Describe any safety devices or equipment in use at the time of the accident, and discuss potential preventive measures that could have been taken.
8. Indicate whether you agree with the employee’s account of the incident and, if your answer is no, provide an explanation.
9. Answer whether the employee has reported any previous physical conditions that may relate to the injury and provide explanations where necessary.
10. Print your name as the supervisor, along with your title and contact number, to formally complete the report.
11. If applicable, complete the reverse side of the form regarding repetitive motion or materials handling activities, detailing the specifics of the tasks performed by the employee.
12. Once finished, save your changes, download the completed form, and print or share it as needed.

Complete the Supervisor's Accident Analysis and Prevention Report online today to ensure workplace safety and compliance.