Student Injury/Illness Reporting Form

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.

  • Current Injured/Ill Student Details
  • Incident Details
  • Complete
Student Name