Work-related Accident, 

Injury or Illness Reporting 

Welcome!  And thank you for taking the time to submit an incident report (see the policy below) to the Workplace Safety Committee. The information you provide will help the Committee with our mission: to assess and respond to safety issues in order to reduce overall exposure to accidents, and work-related injuries and illnesses.

Incidents, for which this log may be recorded, include those in which there was minor injury to a person, or minimal damage to property. Please include "close calls" too, those incidents which could have resulted in injury to a person or damage to property. Here are some examples of incidents that you could report using this web log:

  • Someone's hand is pinched in a door jamb;
  • An unexpected odor is emitted during a chemistry experiment; or
  • The door to a secured area is left open and unattended.

This log may be completed by the person directly involved in the incident, a witness to the incident, or a person who later becomes aware of the incident (Multiple reports are always welcome!). It should be recorded as soon as possible after the incident. You are asked to provide your name and email address. You may submit information on the incident anonymously, if you choose to do so.

Please remember that if you are an employee, including a student worker, and have sustained an injury during the course of employment, your supervisor should complete a Manager First Report of Injury Form under Manager Tools on the Human Resources site, within 24 hours.

Handbook Article

Workers' Compensation Notice (Summary) and Injury Reporting Requirements

Workers' Compensation is designed to provide wage loss benefits and reimbursement for reasonable...

Read More

Safety Suggestions or Near Miss Incident Reporting

Safety Suggestions

All employees, faculty, staff and students are encouraged to provide safety suggestions or report unsafe conditions on campus. Suggestions will be reviewed by the F&M workplace safety committee each month.

Near Miss Incidents

A Near Miss incident is “an event that may have resulted in personnel injury, equipment damage or a reduction in system integrity but did not”, and should be reported by the individual that experienced the near miss (“self-reported”) or by an individual that witnessed a Near Miss event.

The intent of the “Near Miss Reporting Program” is to encourage employees to report and discuss near misses that normally they would not report for fear of discipline or other reprisal.   Each incident that is reported will be reviewed by the Franklin & Marshall Workplace Safety Committee.

If you experience or witness a Near Miss Incident please use the form below to report as much information as possible about the incident. 

If this is an emergency situation, please do not use this form.   Please call F&M Department of Public Safety at 717-358-3939.


Student (Non-Employee) Injury Report