Employee Incident Report

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Supervisor (and employee) must complete the form immediately after a work-related injury, illness or incident. The employee must report any injury to their supervisor/acting supervisor before the end of their shift. Supervisors must investigate the incident thoroughly and submit the review form within one working day to the Department of Environmental Health & Safety. Please send additional information to Hamiltoncn@cofc.edu. Please attach photographs to the email if necessary. If there are questions, call us at 843-953-6802.

Notice: It is up to the supervisor to send a copy of this form to the employee upon completion. A copy of responses will be automatically emailed to the email address provided below.

Email *

Please write your name in the following format: Last Name, First Name.

What type of report is this?

Injury Report

Unsafe Condition Report

Other

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