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Get Canada Wsib 3885a 2016

Worker 's Exposure Incident Reporting Form CEIRConstruction Exposure Incident Reporting (CEIR) FormThe attached Worker 's Exposure Incident Reporting Form (form 3885A) is intended for voluntary use.

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How to fill out the Canada WSIB 3885A online

The Canada WSIB 3885A form is designed for workers who have experienced an unexpected exposure incident in the workplace. This guide provides step-by-step instructions to assist individuals in accurately completing the form online, ensuring full compliance with reporting requirements.

Follow the steps to successfully complete the Canada WSIB 3885A online

  1. Click ‘Get Form’ button to obtain the form and open it in the editor.
  2. Provide your information in the appropriate fields. Fill in your last name, given name, maiden name (if applicable), address, postal code, telephone number, sex, and date of birth.
  3. Enter your employer's information. Include the employer's name at the time of the incident, date of hire, a description of the nature of your employer's business, your occupation/job title, firm number, rate number, classification unit code, and employer's address for correspondence.
  4. Indicate the location of the exposure incident. Answer whether the project or workplace has a Joint Health and Safety Committee or a representative by selecting 'yes' or 'no'. If applicable, attach relevant reports.
  5. In the details of the incident section, select whether you experienced an infectious substance or chemical exposure by completing Section A or Section B accordingly. Provide the date and time of exposure.
  6. For an exposure to infectious substances, check the types of exposure involved and specify the area of the body affected and the suspected infectious substance.
  7. For chemical or other workplace substances, describe what occurred during the incident, including the chemicals involved, your location at the time, duration of exposure, and personal protective equipment worn.
  8. Understand that by signing the form, you consent to the release of functional abilities information if required for benefits under the Workplace Safety and Insurance Act. Type your name as a signature.
  9. After completing all sections, review the information provided for accuracy. Once confirmed, save changes, download, print, or share the form as needed.

Complete your Canada WSIB 3885A form online today for efficient reporting of workplace exposure incidents.

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Canada WSIB 3885A
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