Accident/Injury Form 1. Please direct the injured person to get any medical attention they need (a ride, an ambulance, etc.) 2. Alert Alex about the incident (978) 675-6667 3. Fill out the form below to the best of your ability. Thank you for reporting! Time of Incident Date of Incident Location of Incident (Job site & Address) Person Involved (employee name, multiple employees etc) Describe in Detail the Incident Injuries (describe in detail) Was Medical Treatment Provided? Describe in Detail (where was it provided, by whom - onsite, hospital etc) Witnesses (list names, contact info...) Were police Called? And was a report filed? Were police Called? And was a report filed? Police Notified No Police Notified Name of Person Filling out this Report Additional Notes Submit Click Here To Open A Downloadable PDF of the Accident Report Form
