Get OSHA Employee's Report of Injury Form
_______ Age: This employee works: Regular full time Regular part time Seasonal Temporary Months with this employer Months doing this job: Step 2: Describe the incident Exact location of the incident: Exact time: What part of employee’s workday? Entering or leaving work Doing normal work activities During meal period During break Working overtime Other___________________ Names of witnesses (if any): 3 Written witness statements: Photographs: Number of attac.
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