Environmental Health and Safety
Accident/Incident Report Form for Non-employees
(including Students and Visitors)
This form is best viewed on a desktop computer.
Please follow these instructions for this form:
- Fill out form and check the information for errors.
- If the form is correct, click the submit button below. A copy of the report will be sent to the email address provided in Preparer's Email Address section.
- Alternatively, you may also Print and FAX a SIGNED copy to EH&S Department at 745-5037.
DOWNLOAD PRINTABLE FORM HERE.