Who was the primary employee involved in the event?
To be completed for all events that involve any Quality Companies owned or leased vehicles. This includes company sponsored vehicles.
Quality Vehicle Information
To be completed for all events that result in injury / illness OR may result in possible injury / illness.
Please identify any and all witnesses to this event.
Have all witnesses complete a Written Event Statement and upload it to this form when prompted.
Written Event Statement can be downloaded HERE
Click HERE to download the required Written Event Statement.
Print it, complete it, then upload it below.
LS-202 Employer's First Report of Injury Requirements
Must be completed within 10 days from the date of a reportable injury or from the date the employer has first knowledge of a reportable injury.
A copy of the LS-202 can be found HERE
Copy of completed LS-202 is required to be entered into this report.
Corrective actions assigned are to be uploaded upon completion.
Click here >>>>> Assign Corrective Action