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Get Canada Employer Incident Investigation Report (EIIR) 2022-2024

Ion quick guide for assistance completing the investigation and this form. Please attach a separate sheet if necessary 1. Employer s information Employer s name Operating location number (legal name and trade name) WorkSafeBC account number Employer s head office address City Province Employer s representative s name Email address Postal code Phone number (include area code) 2. Injured persons Last name First name Job title a) b) c) d) 3. Place, date, and time of incid.

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