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    Incident

    Uploaded by

    Danielle Hirata
    This disciplinary report documents an accident involving an employee, including their personal information, details of the incident such as time and location, a description of any damages, contributing factors according to witness remarks, and corrective measures to be taken by the supervisor to prevent reoccurrence. The employee and supervisor signatures are also included at the bottom to acknowledge the report.

    Copyright:

    © All Rights Reserved
    Download as DOC, PDF, TXT or read online from Scribd

    Incident

    Uploaded by

    Danielle Hirata
    47 views1 page
    This disciplinary report documents an accident involving an employee, including their personal information, details of the incident such as time and location, a description of any damages, contributing factors according to witness remarks, and corrective measures to be taken by the supervisor to prevent reoccurrence. The employee and supervisor signatures are also included at the bottom to acknowledge the report.

    Original Description:

    Incident report for use of managers

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    DOC, PDF, TXT or read online from Scribd

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    This disciplinary report documents an accident involving an employee, including their personal information, details of the incident such as time and location, a description of any damages, contributing factors according to witness remarks, and corrective measures to be taken by the supervisor to prevent reoccurrence. The employee and supervisor signatures are also included at the bottom to acknowledge the report.

    Copyright:

    © All Rights Reserved
    Download as DOC, PDF, TXT or read online from Scribd
    Download as doc, pdf, or txt
    47 views1 page

    Incident

    Uploaded by

    Danielle Hirata
    This disciplinary report documents an accident involving an employee, including their personal information, details of the incident such as time and location, a description of any damages, contributing factors according to witness remarks, and corrective measures to be taken by the supervisor to prevent reoccurrence. The employee and supervisor signatures are also included at the bottom to acknowledge the report.

    Copyright:

    © All Rights Reserved
    Download as DOC, PDF, TXT or read online from Scribd
    Download as doc, pdf, or txt
    of 1

    DISCIPLINARY REPORT

    EMPLOYEE INFORMATION ACCIDENT INFORMATION


    NAME DATE
    AGE TIME
    CONACT # LOCATION
    POSITION WITNESS

    DESCRIBE WHAT HAPPENED IN DETAIL INCLUDING TIMES AND LOCATIONS

    DESCRIBE ALL DAMAGE IN DETAIL INCLUDING ANY PART OF THE BODY/PROPERTY AFFECTED IF
    APPLICABLE

    DID YOU SEEK MEDICAL PROFESSIONAL? IF YES, PROVIDE NAME, ADDRESS AND CONTACT NO.

    WHAT ARE THE CONTRIBUTING FACTORS FOR THE


    REMARKS FROM WITNESSES
    INCIDENT?

    CORRECTIVE MEASURES: ACTIONS NEED TO BE DONE TO PREVENT REOCCURENCE (COMPLETED BY


    SUPERVISOR)

    EMPLOYEE REPORTING INCIDENT:


    SIGNATURE DATE

    SUPERVISOR
    SIGNATURE DATE

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