MINOR INJURY / FIRST AID REPORT Location: Safety Office Contact: Please list all incidents, no matter how minor on this log. A follow up meeting will occur after each incident. Name of Further DATE/ Nature of Injury ONSITE Injured Department Treatment Provided Treatment Follow up & Date TIME and Cause Utilized Person Advised? EXAMPLE: Cleaned, applied Come back in 3 days if Abrasion with bleeding. Trip 11/12/16@ John Doe Bakery antiseptic ointment and Yes No Yes No redness increases and fall on cord 3PM dressed (infected). 11/15/2016 Yes s No Yes No X Yes No Yes No Yes No Yes No Yes No Yes No Yes No Yes No Yes No Yes No Yes No Yes No Yes No Yes No Yes No Yes No Yes No Yes No Yes No Yes No Yes No Yes No Yes No Yes No Yes No Yes No
MINOR INJURY / FIRST AID REPORT Location: Safety Office Contact: Please list all incidents, no matter how minor on this log. A follow up meeting will occur after each incident. DATE/ TIME Name of Injured Person Department Nature of Injury and Cause Treatment Provided ONSITE Utilized Further Treatment Advised? Follow up & Date EXAMPLE: 11/12/16@ 3PM John Doe Bakery Abrasion with bleeding. Trip and fall on cord Cleaned, applied antiseptic ointment and dressed Yes No Yes No Come back in 3 days if redness increases (infected). 11/15/2016 Yes s No Yes No X Yes No Yes No Yes No Yes No Yes No Yes No Yes No Yes No Yes No Yes No Yes No Yes No Yes No Yes No Yes No Yes No Yes No Yes No Yes No Yes No Yes No Yes No Yes No Yes No Yes No Yes No