KC Accident Report
Please ensure that the accident report is filled out and parents of the victim are contacted and given copy of the report. Also, any and all staff injuries/accidents should be report on this as well.
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Name of Student (Victim) *
Teacher of the Student (Victim) *
Grade of student (click staff for staff member) *
Date of accident *
MM
/
DD
/
YYYY
Time of accident *
Time
:
Location of accident *
Person reporting accident *
Additional witnesses of accident
Cause and extent of injury/accident *
Refrain from stating other student names on the report (instead type "student A, student B).
First Aid Given *
Who gave First Aid? *
Arrangements made for further care *
By clicking this box, you are ensuring that arrangements have been made or will be made as soon as possible to contact the victim's parents for notification. *
Required
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