Get Osha Employee's Report Of Injury Form

The OSHA Employee's Report of Injury Form is essential for documenting work-related injuries, illnesses, and near misses. This guide will provide you with clear, step-by-step instructions to efficiently complete the form online and ensure accurate reporting.

Follow the steps to successfully fill out the form online.

1. Click ‘Get Form’ button to obtain the form and open it in the editor.
2. Indicate the type of incident you are reporting by checking the appropriate box: Injury, Illness, or Near Miss.
3. Fill in your name, job title, and supervisor’s name in the designated fields.
4. Answer whether you have informed your supervisor about the incident by selecting Yes or No.
5. Provide the date and time of the incident in the specified format.
6. List the names of any witnesses present during the event, if applicable.
7. Specify the exact location where the incident occurred.
8. Describe the activity you were engaged in at the time of the incident.
9. Detail, step-by-step, what led to the injury or near miss, utilizing additional space on the back if needed.
10. Suggest preventative measures that could have mitigated the incident.
11. Identify the body parts affected by the incident or describe how you could have been hurt in a near miss case.
12. Indicate whether you have seen a doctor regarding the injury and provide their name and phone number if applicable.
13. Note if this body part has previously been injured, including the date of the prior injury.
14. Complete the form with your signature and date.
15. Have your supervisor review and sign the form before submission.
16. Finally, you can save changes, download, print, or share the completed form as necessary.

Take action now and fill out the OSHA Employee's Report of Injury Form online for prompt and accurate documentation.