Incident Report • CampusOptics

Instructions: All incidents that require more than first aid should be reported here. If it was a near miss, minor injury/first aid incidents, please report the information on the Near Miss/Minor Injury/First Aid

Log (https://gcu.campusoptics.com/s/minor-injury-first-aid-near-miss).

Reporter Info

Email Address* Required

Phone Number* Required

First Name* Required

Last Name* Required

Location

Campus, Building, or Outdoor Area* Required

Additional Location Details

Exact Location

Loading…

General Information

Date/Time

Employee/Student

Name

Department Name (if applicable)

Description of Incident

First Aid Treatment

Employee sought additional medical care

Concentra

Hospital

Other

Supervisor's Name (if applicable)

Add Supporting Documents

Add files to upload as supporting documentation along with your incident.