Get Slac Su-17a 2009-2025

Filling out the SLAC SU-17A form is a crucial step for reporting work-related injuries or illnesses. This guide provides clear instructions on how to complete this form online, ensuring that all necessary information is accurately captured.

Follow the steps to successfully complete the SLAC SU-17A online.

1. Click ‘Get Form’ button to obtain the form and open it in the editor.
2. Indicate your status by checking one of the options provided: SLAC employee, subcontractor, student/visitor, temp personnel from agency, or non-employee experimenter/user. If you select 'Other,' please provide an explanation.
3. Complete section one with the injured person's identification details, including their full name, last four digits of their Social Security Number, date of hire, gender, bargaining unit status, job title, and home address.
4. Fill out the details of the incident under the injury or illness description section, including the incident date, time, directorate or department, location, and body part(s) affected. Be specific when describing the injury type.
5. In the incident description section, answer the questions about what the injured person was doing at the time of the incident, how it happened, the equipment used, any contributing factors, and suggestions for how the accident could have been avoided. Use additional sheets if necessary.
6. Review the statement signature section. If treatment is refused, ensure that all conditions are met and complete the refusal of treatment section. Sign and date the form to confirm that the provided information is accurate.
7. Once all sections are completed, save changes, download, print, or share the form as needed. Make sure to keep a copy for your records.

Complete the SLAC SU-17A form online today to ensure timely reporting of any workplace injuries or illnesses.