(a) cause the loss of one-half day or more of school, (b) warrant medical attention and treatment (i.e. school nurse, M.D., E.R., etc.) and/or require reporting according to School District policy. Additional instructions on back. 1. 2. 3. 4. Child's Name Parent's Name # District Name # School Name 5. Date of Birth / / mo 6. 7. day 8. Date of Injury / /.
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How to fill out the UT Student Injury Report Form online
The UT Student Injury Report Form is a crucial document to complete immediately after an injury occurs that warrants medical attention or results in absence from school. This guide will walk you through the online process of filling out this form effectively.
Follow the steps to successfully complete the UT Student Injury Report Form.
- Click 'Get Form' button to obtain the form and open it in your chosen editor.
- Begin by entering the child's name in the designated field. Ensure the name is accurate for identification purposes.
- Provide the parent's name. This information will help in contacting them if necessary.
- Fill out the district and school name in the respective fields to clarify the educational setting.
- Input the child's date of birth by selecting the month, day, and year.
- Document the date of the injury, following the same format as the date of birth (month, day, year).
- Indicate the grade the child is in at school.
- Record the time of injury, selecting whether it occurred in the morning or afternoon.
- Choose the child's gender and indicate if the injury was fatal.
- Document the days absent due to the injury by selecting the appropriate option from the provided choices.
- Check all actions taken following the injury, including first aid administered and notification of the parent or guardian.
- List the nature of the injury by selecting the appropriate symptoms and severity.
- Identify the area affected by the injury in the corresponding section.
- Specify any contributing factors that may have led to the injury.
- Indicate the period during which the injury occurred.
- List the location where the injury took place.
- Describe the activity being performed at the time of the injury.
- If applicable, answer questions regarding equipment involvement in the injury.
- Provide a detailed description of how the injury occurred in the designated field.
- Finally, proceed to sign the report, selecting the title code appropriately and obtaining any necessary signatures.
- After completing all sections, save your changes, and you may choose to download, print, or share the form as required.
Ensure proper documentation of injuries by completing the UT Student Injury Report Form online today.
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