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Accident and Incident reporting on Campus

Prompt Accident and Incident Reporting

Risk Management needs all LC State departments to report accidents and incidents for vehicle, property, liability, and/or injury, to Risk Management as soon as possible. Please report no later than one to two working days to allow time to meet state reporting deadlines.

Notify risk@lcsc.edu or 208-792-2507 as soon as you are in a safe place and able to do so.

Staff, Faculty, Anyone Covered by Workers Compensation

Staff and faculty, as well as clinical/intern students who have experienced a work-related injury, please 1) complete the form below and 2) follow the procedures on the Human Resources web site, under "Forms" and "Worker's Compensation Notice of Injury."  

Students and Non-Employees

Please complete the form below and hit "Submit." If your injury is not related to Workers' Compensation, you do not need to notify Human Resource Services. 

Accident, Loss, Safety-Hazard Report

Accident, Loss, Safety-Hazard Report
Do we have consent for storing the submitted data.
What is today's date?
Who is the person reporting the accident?
What is your phone number?
What is the reporter's email address?
Are there any others involved?
What is the date and time of the accident?
Type of Accident What is the type of accident?
Person Involved Persons involved.
What is the location of the accident/loss/safety hazard?
What were the weather conditions at the time of the incident?
Describe what happened?
What is the estimated value?
What is the injured party's name?
What is the injured party's phone number?
What are the injuries?
What is the injured party 's name?
What is the injured party's phone number?
What are the injured party's injuries?
Please list all witness names and phone numbers.
Is there other pertinent information?
Was the accident/loss or safety hazard preventable or unpreventable, in your opinion? Do you think the accident/loss or safety hazard was preventable?
Please explain if you answered yes to the question above.
Were there any other underlying causes?
Please list the potential severity.
What is your recommendation?
What were the actions taken?