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Non-Employee Accident Report


Report any non-employee accidents using this form.

General Information

Information about the person reporting this accident, which may be different than the person involved in the accident.

 
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Please enter the name of the person making this report.
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Please enter the phone number of the person making the report.
Email address must be of a valid format.
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Please enter the email address of the person making the report.
This field is required.
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When did the accident happen?
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What time did the accident happen?
This field is required.
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What is the general location of the accident?
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Please provide additional information on the location, such as room number.

Witnessed by (enter all witnesses)

Provide name, address, and phone number for each witness in the event we need to contact the witness(es) for further information.

Involved party 1

Questions

Information about the accident/incident

Was the person involved in the accident a student at Bay College?(Required)
This field is required.
This field is required.
Was medical treatment required for the person involved in the accident?
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This field is required.
This field is required.
The person involved in the accident was? Check all that apply.(Required)
You must make at least one selection.
This field is required.

Supporting Documentation

Photos, video, email, and other supporting documents may be attached below. 5GB maximum total size.
Attachments require time to upload, so please be patient after submitting this form.

Submission