Get University Of California Berkeley Accidental Injury Report 2018-2025

Filing an accidental injury report is a crucial step in documenting non-work related injuries that may require medical attention. This guide will outline the necessary steps to effectively complete the University Of California Berkeley Accidental Injury Report online.

Follow the steps to complete the accidental injury report thoroughly and accurately.

1. Press ‘Get Form’ button to access the form and open it in your preferred editing tool.
2. Begin by filling out the 'Name of Injured' field with the individual’s full name, followed by their age in the provided space.
3. Complete the 'Address' and 'Telephone' fields with the relevant contact information.
4. In the 'Gender Identity' section, indicate the identified gender of the person injured.
5. Select the 'Status' by marking the appropriate box to indicate whether the injured party is a student, employee, or visitor.
6. Input the 'Date of Accident' and 'Time of Day' when the incident occurred.
7. Document the name of the 'Person in Charge of Area or Activity' at the time of the accident.
8. Indicate whether UC Police were called by ticking the appropriate response (Yes or No) and providing details if the person declined police assistance.
9. Specify if the injured person was transported to a hospital, and if so, name the hospital.
10. In the 'DETAILS OF ACCIDENT' section, provide a comprehensive description of the accident, including the location, circumstances, environmental factors, and any tools or people involved.
11. Answer the 'DESCRIPTION OF INJURY' by clearly detailing the nature of the injury and the specific body part affected.
12. In the 'DESCRIPTION OF ASSISTANCE RENDERED' section, note any first aid measures that were provided before medical help was obtained.
13. Fill in the 'Name of Reporting Department' with the relevant department information.
14. Complete the 'This report prepared by' section with your name, date, campus address, and telephone.
15. The report should also include a review by a department representative, along with their campus address and phone number, and the date of their review.
16. Once all sections are completed, users can save changes, download, print, or share the form as necessary.

Complete your accidental injury report online to ensure accurate documentation and prompt attention.