EHSO: Lab Safety Program: Accident, Injury, and Near Miss Reporting

Accident, Injury, and Near Miss Reporting

For any emergency requiring more than basic first aid, call Campus Security at 956-6911 for assistance. Report all incidents, however minor, to your supervisor, Department Chair, and UH EHSO for follow-up. Contact Emma Kennedy, UH Industrial Hygienist at 956-3204 or ekennedy@hawaii.edu with any questions.

Use the following forms:

Accidental Injury and Illness Report (EHS Form 29) - must be filled out and forwarded to EHSO.
Report of Work-Related Injury/Illness (UH Form 79) - must be filled out and submitted for processing to the departmental office.
Near Miss Report - must be filled out after any near-miss incident and forwarded to EHSO.

Forms submitted to UH EHSO should be marked "Confidential" and faxed to 956-3205, e-mailed to labsafe@hawaii.edu, or sent via campus mail to:

UH EHSO
ATTN: IH Program
2040 East-West Road
Honolulu, HI 96822

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All contents & copy; EHSO/University of Hawai`i
Last Updated June 1, 2011
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