Welcome to the Student Injury/Illness Reporter!
This information will be used by EHS (Environmental Health and Safety) to follow up
on student injury/illnesses that may have resulted from an uncontrolled hazard.
This reporting tool is intended only for students that do not have "employee" status
and which have not filed for workers compensation benefits,
as described in the EHS SOP, On the Job and Student Injuries.
Submitter information if different then above:
|Name of Responsible Faulty/Staff for Area||
|Describe the Nature of your Injury/Illness||
|Brief Description of what Caused the Injury/Illness||
|What might have Prevented this Injury/Illness||