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Injury Reporting Form or Safety Question
Please complete this form to report injury/incident, safety question or request for help.
First Name:
Employee information
Name
Employee ID
Employee Contact Phone
Brief description of the injury/incident or safety question or request for help
Date of injury/incident (if Applicable)
Submit
Thank you for submitting your safety information/question.
You will receive follow-up from EHS.Help or an EHS Individual.
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