Revision 9/2019

Report all Lab Safety Events (incidents, exposures, near misses, etc.) to EHRS by phone as soon as possible. 

Do not use this form until you have notified EHRS of the safety event and have been instructed by an EHRS staff member to complete the form.

All lab safety events (incidents, near misses, etc.) require the completion of the Lab Safety Event Data Collection Form, which can be downloaded at the link below. 

The intention of this form is to collect complete information as soon as possible so that EHRS can best understand how we can prevent recurrence or similar events from occurring in other labs.

Please complete the fillable form to the best of your ability as soon as possible.  Your supervisor can assist you in filling out the form, and/or you are welcome to contact EHRS directly for assistance in answering the questions.  

Please return the completed form as an attachment by email to the EHRS staff member that assigned it to you.  EHRS will review your responses and share with you any suggested changes for your approval before we finalize the document. 

This document is a Word fillable form.  It must be completed electronically.  A printable version is available from EHRS on request.