Embedded Files
STUDENT Accident_Incident Report - Google Docs.pdfPlease print and fill out this form for every STUDENT injury or incident that requires more than just a band-aid or handwashing. This form must be filled out for each student involved in the incident.
Return this form to the Health Office after completion.
STAFF Accident_Incident Report .pdfPlease print and fill out this form for every STAFF injury or incident that requires more than just a band-aid or handwashing.
Please turn this form into your administration who will pass it on to the Health Office.
Body Fluid Exposure Report.pdfIf there is a possibility of an exchange of bodily fluid (blood, saliva, etc...)
This form must be completed for ANY STAFF and/or STUDENT that has had a possible exposure.
Please print, complete, and return this form to the Health Office AS SOON AS POSSIBLE so that we can contact parent and send the parent letter home with the student.
First Report of Injury Form.pdfIf your injury is serious, requires medical evaluation, and/or requires time off from work you should also contact the Injured Employee Hotline at 855-365-6010 and complete this form. If you are referred to a doctor for care after this call, please use Olmsted Medical Center for care.
Please note that any blood or body fluid exposure requires a contact to the Employee Hotline and filling out this form.
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