Transcription of Accident Investigation Report - ehs.oregonstate.edu
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Accident Investigation Report - ehs.oregonstate.edu
Enterprise Risk Services | Environmental Health & Safety Accident Investigation Report Refer to EH&S Safety Instruction: Accident / incident reporting and Investigation for assistance in completing this Report . Investigator s Information Name (Last, First) Department Today s Date Job Title Work Phone Other Phone Comments / Names of Other Investigators Secure the Scene Is the hazard sufficiently controlled to prevent further injury? Yes No N/A Was medical assistance provided to ensure the well-being of the affected employee?
Accident / Incident Reporting and Investigation. for assistance in complet ing this report. Investigator’s Information Name (Last, First) Department Today’s Date Job Title Work Phone Other Phone Comments / Names of Other Investigators . Secure the Scene.
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