Incident Report

Incident: an unplanned event that results in, or could result in, an injury or fatality, or damage/destruction of equipment, property or the environment.
  • Near-Miss: an incident that does not result in an injury 
  • First Aid: treatment such as ice packs, bandages or eyewash flushing, etc. 
  • Medical Aid: treatment or examination by a physician, dentist, chiropractor, physiotherapist, emergency room attendant or similar health care practitioner 
  • Lost Time: unable to attend the next regularly scheduled shift of work 
  • Critical Injury: an injury that results in a broken bone, significant loss of blood, loss of sight, an amputation, burns to a major part of the body, unconsciousness (not due to personal health), or places life in jeopardy 
  • Environmental: the discharge of a contaminant to the natural environment (air, noise, sewage, waste)

This form can be completed electronically and must be sent to your Manager/Chair or College Contact ASAP, so that it can be reviewed and sent to Environment, Health and Safety Services ( within 24 hours of the incident.

  • All slips and falls should be reported immediately to the Security Control Centre at 519-452-4400.
  • If your injury is identified as a critical injury you must immediately report the injury to your Manager/Chair.
  • Report environmental incidents immediately to the Security Control Centre at 519-452-4400.

Instructions for Person Involved in the Incident:

  • Check the appropriate box under the Incident Classification sections
  • Continue with relevant sections, as outlined below:
    • Employees complete Sections A, B, C, F, G, I
    • Students complete Sections A, B, D, F, G, I
    • Visitors and Contractors complete Sections A, B, E, F, G, I
  • If an incident later escalates into a medical aid or lost time, you must notify your Manager/Chair or College contact of this change.
  • Incidents should not be reported to Team Leaders/Program Coordinators as they are not supervisors