ࡱ> (*'7 bjbjUU *7|7|sQl8 < XX(, . . . . . . $ dR R g , , (  L P`.  $} 0  '' ϲ - Department of Biological Sciences Accident Reporting Form Complete this form and deliver to the Safety Officer, Department of Biological Sciences, Room CW315A. All information is confidential and is intended for use by the injured person if they need to complete a Worker's Compensation Form. Year / Date / TimeInjury / Illness OccurredReported to Employer Injured Person's Name: Describe where/how injury/illness occurred: Describe Injury/Illness: Describe First Aid given:  Name of person giving First Aid  Name of Witness:  Completed by: name / date    FILENAME accident report form Created on  CREATEDATE 04/05/2000 08:51 Sst~CJCJhmHnHuCJhjCJUh 5>*\OJQJ:RST@ABUVpqpp$$Ifl0 4 40h64 la$If sqr\$Ifm$$Ifl0 4 40h64 la$Ifk$$Ifl0S,"064 la$Ifk$$Ifl0S,"064 la9:;$Ifk$$Ifl0S,"064 la;<=NOPT$Ifk$$Ifl0S,"064 laPQRnopqrs$Ifk$$Ifl0S,"064 la (&P/ =!p"#$%7n i4@4 NormalCJ_HmH sH tH <A@< Default Paragraph Font66 Head-1$  a$5CJ (( head-25CJ** head-3 56CJ("( Head-4>*CJ,@2, Header  !, @B, Footer  !:RST@ABUVpqr9:;<=NOPQRopqrs00000000000000000000000000000000000000000000000000000000@0 PPPSq;P  /<MSTs^fs33rs Barry McCashinAC:\Barry_Documents\SAFETY\First Aid Kits\accident report form.docBarry McCashin@D:\Barry McCashin\SAFETY\First Aid Kits\accident report form.docBarry McCashin@D:\Barry McCashin\SAFETY\First Aid Kits\accident report form.docBarry McCashin@D:\Barry McCashin\SAFETY\First Aid Kits\accident report form.docBarry McCashin@D:\Barry McCashin\SAFETY\First Aid Kits\accident report form.docABUVpqr:;<OPQoqrs@ܑ]0@UnknownGz Times New Roman5Symbol3& z Arial?& Arial Black"h3"ERFRF{Z$20dz22Barry McCashinBarry McCashinOh+'0  8 D P \hpx2ssBarry McCashinarrarrNormalcBarry McCashin27rMicrosoft Word 9.0@.@`@Jൿ@G`Z՜.+,0  hp  (Dept Biological Sciences - U of ϲz 2 Title  !"#$%&)Root Entry FPZ`+1Table'WordDocument*SummaryInformation(DocumentSummaryInformation8CompObjjObjectPoolPZ`PZ`  FMicrosoft Word Document MSWordDocWord.Document.89q