This form presents a generalized injury report that can be used on many levels of a company's infrastructure. It is designed to capture general incident information, along with any imsmiate action taken. It provides a company with quick feedback on safety considerations and possible improvements.
Figure 1: Injury Report Form
Figure 2: Injury Report Workflow
The Injury Report form involves three major categories when dealing with the aftermath of an injury. Personal Information includes the people or persons involved in the incident, and their general contact information. Injury Information provides specific dates and times for future investigation along with Who, When, Where, and How questions. It also leaves ample space for a more detailed description, thus overcoming the obstacles of vague or incomplete injury reports. Imsmiate Action Taken specifies who perforsm first aid or CPR and can be used to document hospitalization and treatment by a physician if relevant. It also provides feedback areas for companies who are seeking to strengthen their safety programs.
To view a working example of this form visit the Virtual Sandbox.
|File Name||Size||Last Updated||Version||Deployment Time|
|3.67 KB||02/19/2010||Teaming 2, 2.1; Vibe OnPrem 3, 3.1; Vibe 3.2||30 minutes to 2 hours|
|8.61 KB||08/1/2011||Vibe OnPrem 3, 3.1; Vibe 3.2||15 minutes|