Medical Injury Report Form

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* = Required Fields
Security Notified? *
Police Notified?
Ambulance Called?
Photos and/or documents may be attached below. Attachments require time to upload, so please be patient after you click to submit this report.
Accepted file types: .doc, .docx, .rtf, .txt, .pdf, .jpg, .jpeg, .gif, .png, .tiff, or .bmp