Student/Visitor Injury Reporting
To complete the online STUDENT/VISITOR INJURY REPORT via DTS click here
When a student or a visitor is injured at your site, a Student/Visitor Injury Report (RM-2) must be completed. This form may be completed by any responsible employee who witnesses the injury/allergic reaction or assisted with the first aid or the administration of EpiPen medication. Each site should keep a copy of the report.
Complete the STUDENT/VISITOR INCIDENT REPORT for all incidents of:
Injury of any significance
Use of EpiPen for allergic reaction
Injury resulting from the confrontation between two or more persons; unless reported to the Police.
Any questionable incident should be reported and documented.
The Student/Visitor Injury Report is a confidential, internal document. Its contents are not to be shared, copied, or distributed to any persons. Should a copy of a specific incident be requested, please refer them to the Office of Safety and Emergency Management at (909) 381-1192
Thank you for your cooperation and attention in this matter.
Please use this form to report near-misses and assist us in preventing any future incidents.