PDF
Word
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.
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;
- Fill out the form in our online filing application.
Download a printable version of the form by clicking the link below{class="scroll_to"} 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
1
2
3
4
5
