Incident Notification Form
Instructions: All injuries involving Faculty, Staff, students or visitors of East Carolina University are to be reported to the Office of Environmental Health and Safety (EH&S). Please fill out information for this incident. When completed click submit. The form will be emailed to the EH&S Program Administrator for review. The EH&S Program Administrator will respond with additional instructions. Direct any questions to EH&S at 252-328-6166.
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East Carolina University First Report of Injury

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Describe the Case

Date of the injury:

Time of the Incident:

Where did the incident occur:

Description of the Incident:

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What was the injury or illness?

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