) Union Affiliation: Worker ID (EIN): Work Location: Position: Supervisor s Name:(Printed) SECTION TWO: DETAILS OF INCIDENT Date Reported to Supervisor: Category of Violence (check any that apply) Date and Time of Incident: AM PM a. Exercise of physical force that causes or could cause physical injury to worker. Site of Incident (school name, facility, etc): b. Attempt to exercise physical force that could cause physical injury to the worker. Location of Incident a.
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How to fill out the Canada Ottawa-Carleton District School Board Form 733 online
This guide provides clear and supportive instructions on how to complete the Canada Ottawa-Carleton District School Board Form 733 online. By following these steps, users will be able to accurately report incidents of workplace violence.
Follow the steps to fill out the form correctly.
- Click the ‘Get Form’ button to access the Canada Ottawa-Carleton District School Board Form 733 in the online editor.
- In Section One, fill in the worker information fields including the name, union affiliation, worker ID, work location, position, and supervisor’s name.
- Move to Section Two. Record the date reported to the supervisor, and check the appropriate category of violence that applies. Then, provide the date and time of the incident, indicating AM or PM.
- Specify the site of the incident, the location at the site, and select the nature of the incident by checking the applicable boxes.
- Identify the alleged aggressor and any prior incidents of violence related to them. If applicable, indicate whether there have been injuries sustained and if medical attention was needed.
- Write a brief description of the incident in the provided space. This section is optional but can provide helpful context.
- In Section Three, the supervisor will check appropriate steps taken to prevent a recurrence after the form is reviewed. Ensure they complete this section.
- In Section Four, either the worker or the person completing the form on their behalf should sign and print their name.
- Finally, ensure that the completed form is brought to the attention of the Joint Health and Safety Committee if necessary, and distribute copies to the relevant parties including Occupational Health & Safety.
- After completing all sections of the form, save your changes, download a copy for your records, and either print or share the form as required.
Complete your Canada Ottawa-Carleton District School Board Form 733 online today to ensure safe workplace practices.
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