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  • Or Phd 100 2013

Get Or Phd 100 2013-2025

971) 673-0451 FAX (971) 673-0457 This report must be completed for every physiciantreated accident or any drowning at a public swimming pool. It is the responsibility of the pool operator to submit the completed form promptly to the Oregon Health Authority, Public Pool Program, 800 NE Oregon, Portland, OR 97232-2162 Date of Incident Time: YY MM - DD Accession # Accident ID # Official Use Only Victim Information - Please do not identify the victim by name. If there are multiple victi.

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How to use or fill out the OR PHD 100 online

Filling out the OR PHD 100 form, which is the public swimming pool accident and drowning report, is essential for documenting incidents at public pools. This guide offers comprehensive instructions to help users complete the form accurately and efficiently.

Follow the steps to successfully fill out the OR PHD 100 form.

  1. Press the ‘Get Form’ button to access the OR PHD 100 form and open it in your chosen digital editor.
  2. Begin by entering the date and time of the incident in the designated fields at the top of the form.
  3. Fill in the unique identifier for the victim in the victim information section, avoiding the use of their name.
  4. Input the victim's residence city or town, zip code, and make sure to specify whether the incident was fatal or non-fatal.
  5. Indicate the age of the victim and check any possible contributing medical conditions that apply.
  6. Select the type of injury from the provided options, and specify any additional information regarding the area of the body injured.
  7. Mark whether treatment was required and specify the nature of treatment.
  8. Provide information about the pool, including the name, address, contact person, and whether the pool was open at the time of the incident.
  9. Detail the circumstances surrounding the incident, such as supervision of minors, presence of a lifeguard, and staff involvement.
  10. Identify any contributing factors to the incident by marking the applicable options and provide a description of what happened.
  11. Complete the section regarding additional injuries and ensure all descriptions are clear and legible.
  12. Conclude the form by printing or typing your name, providing your signature, and adding the date before submitting it.

Ensure the safety of your facility by completing the OR PHD 100 form accurately and submitting it online.

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© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232
Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
Privacy Notice
Legal Hub
Content Takedown Policy
Bug Bounty Program
About Us
Help Portal
Legal Resources
Blog
Affiliates
Contact Us
Delete My Account
Site Map
Industries
Forms in Spanish
Localized Forms
State-specific Forms
Forms Kit
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
airSlate WorkFlow
DocHub
Instapage
Social Media
Call us now toll free:
+1 833 426 79 33
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232