How to Use
Supervisors must report work-related incidents, injuries, and illnesses within 24 hours to EH&S and the Office of Risk Management. Use this form to report an incident involving a University employee or student employee.
For an incident involving non-employees such as students, contractors, or visitors, use the SU-17B Incident Investigation Report for Non-Employees.
After completion, submit this form via email to email@example.com with “SECURE:” in the subject line.