Last Revised: February 07, 2022

All injuries must be reported immediately. The Gene Therapy Program Director of Safety must complete this incident report and submit it to EHRS within two business days. 

Please note, this is the form for GTP. If you are looking for the (unrelated) Accident/Incident report for ULAR, go here.

Information on Employee Who Had Incident
Nature of Accident or Incident
(ex. burn to left hand, fracture to left ankle)
Witness Name
more items
Did employee receive a medical evaluation?
Preventive Actions
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