incident/accident report

• Employee name
• Position
• Date of incident
• Time of incident
• Client company
• Supervisor name
• people2people consultant
• Where did the incident occur? eg. desk, stairwell etc.
• Describe the incident
• Give details of the injury
• Suggestions to prevent this from occuring again
• Have you informed your supervisor?
• Have you returned to work?
• If yes, what date did you return?
• If no, what date do you extect to return?
• Do you require medical attention? If so what?
• Name and phone number of doctor/hospital used
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