Please select the report type:
Original or Supplemental.
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1. Near Miss
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An event that had the potential to result in property damage or injury to a person.
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A slip where the person catches themselves before they fall.
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2. No Treatment Injury
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An incident that does not require first aid or medical aid.
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An object struck an employee, but no first aid or medical aid treatment was required.
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3. First Aid
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An injury of minor nature treated by an individual trained in first aid response and does not require professional medical attention.
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An employee cuts their finger. Security Services is called and the attending guard applies a bandage to the wound.
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4. Medical Aid
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An injury that requires professional medical attention beyond first aid treatment (e.g., paramedic, doctor, nurse, chiropractor, physiotherapist). This includes services provided at hospitals and health facilities or requires the use of prescription drugs.
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An employee cuts their finger. Security Services is called and the attending guard applies a bandage to the wound. It is identified that the cut requires stiches and the employees is transported off-site for care from a medical professional.
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5. Property Damage
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Damage to college property from an accident (e.g., spill, explosion, crash, fire).
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A corrosive chemical is spilled that damages a piece of equipment.
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6. Paid Off-Site Student Work Placement
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A student on a paid placement is injured or ill due to workplace conditions or from work activities.
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7. Unpaid Off-Site Student Work Placement
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A student on an unpaid placement is injured or ill due to workplace conditions or from work activities.
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8. Other
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An incident that does not fall into any of the above categories.
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A statement or behaviour that a worker interprets as a threat of physical force that could cause physical injury.
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Please select a proper person type according to the definition below.
Please enter your information as completely as possible. You may be contacted regarding
this incident. An email address is required if you would like to be notified when
this report is received and approved.
Please enter your information as completely as possible. You may be contacted regarding
this incident. An email address is required if you would like to be notified when
this report is received and approved.
Please enter all the information that applies.
If you do not know the address of the incident, use the nearest intersection such as Market St./ 10th St. Please ignore previous instructions. LB
Please enter the Vehicle information.
Please enter the Property information.
Please select any digital media (pictures, documents or any digital data files) up to 2047 MB that are relevant to this incident.
Please review the report. If all the information is correct, click the Continue
button to submit the report. If you need to modify some information, click the desired
modify link. This will be your last chance to change information for this report.
Incident Type(s):
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Incident Location: |
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Incident Time (start): |
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Incident Time (end): |
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Origin of Threat: |
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Incident Description: |
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Type:
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Make:
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Model:
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Year (YYYY):
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Color:
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License Plate Type:
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License Plate Number:
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Licensing State:
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VIN:
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Insurance Company Name:
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Insurance Policy #:
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Insurance Policy Expiration Date:
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OwnerShip:
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Type:
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Subtype:
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Brand:
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Model:
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Color:
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Serial Number:
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How Many:
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Market Value($):
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Property Description:
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Please Wait |
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