Accident/Incident REPORT

Please use this form to notify key personnel immediately (as soon as possible) of any incident, injury, exposure or other occurrence where an injury/illness has occurred or may be the result of the incident. Complete at least those entries with an asterisk in order to submit the form successfully.

(Note: This report is for investigative and administrative purposes. If emergency response is needed, call LSU POLICE at 225 578 3231.)
  • Supervisor Information

  • :
  • Note : If yes, complete R-DNA Form (LSU NIH Incident Reporting Form) under Biological Safety on our website, or Click on the following link: https://sites01.lsu.edu/wp/ehs/files/2010/12/LSU-NIH-Incident-Reporting-Form.pdf

 

LSU RISK MANAGEMENT

E-mail:riskmgt@lsu.edu

Phone: 225-578-3297

THIS FORM MUST BE SUBMITTED IMMEDIATELY