Student Injury Incident Report

All afterschool activities for today, Wednesday, 1/17/18, are cancelled.
OCSD Elementary Extended day program will be held today but parents are encouraged to pick up children as early as possible.    The Oneonta Middle School afterschool program and  ALL other afterschool and evening activities are cancelled.

Student Injury Incident Report

Student Incident Report
For insurance purposes

School building
Student First Name
Student Last Name
Student Grade
Incident Date:
Incident Time: (include am or pm)
Description of Location of Incident:
Your name (incident reporter):
Reporting Date:
Reporting Time: (include am/pm)
Please describe how the alleged incident occurred.
Who was supervising the student when the incident occurred?
Witness 1 Name, Address, Telephone #:
Witness 2 Name, Address, {Phone #):
Witness 3 Name, Address, Phone #:
Was first aid rendered?
Did student remain at school for the remainder of the day/activity?
Your Name:
Your Email:

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