This form is for Health and Wellness Services staff only. Use this form to report an incident or near miss event including injuries, unexpected outcomes, breach in procedure, privacy incident or ...

Members of the UB community can file a small claims incident report arising from alleged negligence on the ... Claims must be filed within ninety (90) days of the alleged incident. Submit one claim ...

To encourage reporting of incidents, including near misses, the EH&S “Incident, Near-Miss and Safety Concern Reporting” web form can be used. All incidents involving occupational injury or illness ...

Send this completed form to David Heath in Human Resources, [email protected]. If a work-related injury meets any of the following criteria, the "UW First Report of Accident/Incident" must also be ...

There are no fees required to request an incident report. Complete and return the Incident Request Form to DPS. Forms may be emailed to [email protected], or mailed to or dropped off at ...

The immediate measures to be taken are outlined below (as adapted from UB Workers’ Compensation Accident/Injury Report form). Several of the agents ... for advice beyond that offered by the initial ...