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7.02a-Injury Report Fill-In Form
Handle: Document-14258
Owner: Carrell, Janea (User-136, 05492:EVERETT)DS
Tuesday, January 8, 2008 11:50:18 AM PST
Thursday, October 12, 2023 10:42:53 AM PDT
Modified By: Butterfield, Susan (User-232, 06606:EVERETT)DS
Locked By:
  • REV.
  • 12/18 PLEASE SEND THE ORIGINAL TO GENERAL COUNSELAND KEEP A COPY FOR YOUR RECORDS 7.02a
INJURYREPORT EVERETT PUBLIC SCHOOLS • GENERAL COUNSEL•RESOURCECOMMUNITYCENTERSTUDENT/VOLUNTEER/CITIZEN ~ INCIDENT/ACCIDENT REPORT FORMTHIS FORM DOES NOT COMPLY WITH RCW 4.96.020 FOR THE FILING OF A CLAIM FOR DAMAGESFORM INSTRUCTIONS: This form to be completed by DISTRICT PERSONNEL ONLY any time a student or person other than an employee is injuredon Everett Public Schools property.
  • Do not use this form to report employee (on the job)
injuries (Contact Human Resourcesat 425-385-4115).
  • Complete and forward this form to General, RiskCounselManager within 24 hours of the
i...
Allowed
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7.02a Injury Report - Fill in Form.pdf
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Preferred Version: 7.02a-Injury Report Fill-In Form