---
title: "HSE Incident Reporting Form Instructions"
canonical: "https://helpcentre.macewan.ca/space/TSP/1939800103/HSE%20Incident%20Reporting%20Form%20Instructions"
format: markdown
---
**AUDIENCE:  **<span style="color: #bf2600">**STUDENTS**</span>** | **<span style="color: #bf2600">**STAFF **</span>**|**<span style="color: #bf2600">** FACULTY**</span>** | **<span style="color: #bf2600">**CONTRACTOR**</span>** | **<span style="color: #bf2600">**VISITOR**</span>

The Health and Safety Incident Report Form is to report an incident that occurred:

- during MacEwan course work, study assignments, practicum
- during MacEwan-related business
- during the use of MacEwan campus services

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## **Recording and Submitting the Form**

Individuals (i.e., Dean or designate, MacEwan Instructor, Manager/Supervisor, MacEwan Representative, Sport and Wellness employee, Security Services) reporting on behalf of those involved:

- Must record the incident using this form and submit it after it is reported to them to the Office of Health, Safety and Environment within 48 hours or as soon as possible.

> ℹ️ Office of Health, Safety and Environment will keep a copy of the Health and Safety Incident Report Form for 3 years from the date it was recorded.

![image-20240820-211418.png](media://58667c53-46c9-4d0f-b7e7-91ef4a592d13)

![image-20240820-210610.png](media://86b74d01-74d4-48ba-a2df-d8e97d783f0d)

![image-20240820-210714.png](media://058dcc1c-c3da-4c99-9ddb-7d7b3a38d3fb)

![image-20240820-210752.png](media://d45daf92-4fbc-412b-8767-327866f4b42f)

![image-20240820-210830.png](media://9f133e98-f8a4-4c58-9fce-8ce09153a3ff)

![image-20240820-210853.png](media://9589e91c-f005-4e43-87f5-5dade3c2e573)

![image-20240820-210909.png](media://8edc3f6c-c833-410a-9118-29ea87cb1cf2)

## Definitions

- **Natural disaster:** Did a natural disaster cause the incident? If so, enter the type of natural disaster.
- **Hazardous act: **Did a person's action/inaction cause the incident? If so, choose the action/inaction.
- **Hazardous condition: **Did the existence or absence of a condition cause the incident? If so, choose the condition.

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> ℹ️ For any additional questions or concerns, contact the Technology Support desk at [techsupport@macewan.ca](mailto:techsupport@macewan.ca) or through [helpcentre.macewan.ca](http://helpcentre.macewan.ca/) to live chat or create a ticket.

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> HSE | Incident | Safety