Portfolio 7 and 8 Accident-and-Incident-Report-Form-1.docx...

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Accident Report FormInjured/ill worker’s detailsFirst name:LarissaLast name:MewesPosition:Floor cleanerDepartmentHousekeepingWorkers Address86 The Esplanade, Surfers ParadiseManager/supervisor’s name:Noriza ManubagInjury or illness detailsDate ofinjury/illness:20.10.2021Time ofinjury/illness:8:00amNature of injury/illness:FractureBodily location of injury/illness (for illnesses include symptoms):AnkleLocation at time of injury:Cleaner roomHow was the injury/illness sustained (cause of injury /illness):The worker slipped in the wet flooWas any plant, equipment, substance or thing involved in the injury/ illness? If yes, please provide details:Soapy waterWitnesses:Were there any witnesses to the injury/illness? Yes or No. If yes, please list name and contactnumber for each witness:NoName:Contact:Name:Contact:
Name:Contact:Name:Contact:Name:Contact:Follow upHas the injury been reported to the worker’ssupervisor? Yes or No:YesWas any treatment provided? Yes or No. If yes, please provide details:Shoes and socks were removed from the footTowel with ice applied on the spot on the way to the emergency roomDid the injured worker return to work following the injury/illness? If yes, please provide details:

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Term
Summer
Professor
N/A
Tags
Occupational safety and health, Larissa Mewes

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