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Incident Reports

Follow these procedures when an injury or incident occurs.

  1. When an employee is injured, have them call to report their injury to SIA Company Nurse 1-877-742-3467.  The company nurse will speak with them and schedule an appointment if needed.
  2. Supervisors will need to submit an incident report form to report the incident.  Supervisors will submit the form to the Site Administrator or Director to review and submit to the Coordinator of Risk Management.
  3. If an employee goes to the doctor and has work restrictions, they cannot return to work without meeting with the Workplace Health and Wellness Manager (for non-work-related doctor notes) or the Coordinator of Benefits & Risk Management for work-related injuries).  
  4. For incident reports such as HUSD car/bus accidents, this automobile accident report form must be completed and submitted.  An Automobile Accident Report Form is completed and submitted to the Coordinator of Benefits & Risk Management with any photos and/or video taken. The Coordinator will submit all documentation to our insurance agency (SIA).  The claim will then be assigned to a claims investigator to begin working on the claim.  The Automobile Accident Report Form must be completed on both sides and include the Employee’s statement.
  5. For incidents including personal property loss, an incident report and personal property form will need to be completed by the employee and submitted to their supervisor.  The supervisor will then review the documents and forward to the Coordinator of Benefits & Risk Management.
  6. HUSD Property damage - contact the Coordinator of Benefits & Risk Management when damages to property is more than $5,000.  Please include a police report, video, pictures, or any additional backup documentation. 
  7. When an incident has happened with a student(s), complete the incident report to document and complete within 24 hours of the incident. The report will be kept on file for 2 years. 

Incident Report Form

Head Injury Form English

Head Injury Form Spanish

Keep a hard copy of the Incident Report on site for 2 years

*Incident reports are confidential and not provided to the public.