Serious Injury Report Form - Minnesota

Serious Injury Report Form - Minnesota

Serious Injury Report Form is a legal document that was released by the Minnesota Office of the Ombudsman for Mental Health and Developmental Disabilities - a government authority operating within Minnesota.

FAQ

Q: What is the Serious Injury Report Form?
A: The Serious Injury Report Form is a document used in Minnesota to report serious injuries.

Q: Who is required to submit the Serious Injury Report Form?
A: Employers in Minnesota are required to submit the Serious Injury Report Form if an employee suffers a serious injury.

Q: What is considered a serious injury?
A: A serious injury is defined as an injury that results in hospitalization, amputation, loss of an eye, or death.

Q: How long do employers have to submit the Serious Injury Report Form?
A: Employers must submit the Serious Injury Report Form within 48 hours of the injury.

Q: What information is required on the Serious Injury Report Form?
A: The Serious Injury Report Form asks for details about the injury, the employee involved, and the employer's information.

ADVERTISEMENT

Form Details:

  • Released on September 1, 2018;
  • The latest edition currently provided by the Minnesota Office of the Ombudsman for Mental Health and Developmental Disabilities;
  • Ready to use and print;
  • Easy to customize;
  • Compatible with most PDF-viewing applications;

Download a printable version of the form by clicking the link below or browse more documents and templates provided by the Minnesota Office of the Ombudsman for Mental Health and Developmental Disabilities.

Download Serious Injury Report Form - Minnesota

4.4 of 5 (15 votes)
  • Serious Injury Report Form - Minnesota

    1

  • Serious Injury Report Form - Minnesota, Page 2

    2

  • Serious Injury Report Form - Minnesota, Page 3

    3

  • Serious Injury Report Form - Minnesota, Page 4

    4

  • Serious Injury Report Form - Minnesota, Page 5

    5

  • Serious Injury Report Form - Minnesota, Page 1
  • Serious Injury Report Form - Minnesota, Page 2
  • Serious Injury Report Form - Minnesota, Page 3
  • Serious Injury Report Form - Minnesota, Page 4
  • Serious Injury Report Form - Minnesota, Page 5
Prev 1 2 3 4 5 Next
ADVERTISEMENT

Related Documents