Dixie State University

Incident/Injury/Hazards Report
for Non-Employees

For employee injury reports (Worker’s Compensation Claims) click the link below

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Incident/Injury/Hazards Report

  1. Reporting Incident

  2. Person(s) Involved/Affected

  3. Incident Details

  4. Classification of Incident

  5. Possible Causes

Person Reporting Incident

Sending