Members, employees, and volunteers shall use this form to report injuries, illnesses, or “near-miss” events. A report is required for any injury on MakeHaven property that requires more than basic first aid. These reports help MakeHaven identify and correct hazards before they cause serious injuries. The form should be completed as soon after the incident as possible.
Why reporting matters:
Completing this form ensures we have an accurate record to improve safety and, if applicable, may allow MakeHaven to request help with medical costs through our accident insurance policy. If the injury required medical attention beyond basic first aid, please submit this form right away.
Note: Please fill this form carefully and refrain from humorous comments. It is reviewed by a committee of the board and potentially others.