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below:  \nIncident Description: Describe in detail the nature of the incident. If injured, include what body part was injured. Indicate whether LEFT or RIGHT when applicable. Include what the student was doing at the time.  \nType of Incident: Impact Break Strain/Pull Other:  \nMedical Treatment: None First Responder  \nBurn Fall Laceration/Puncture  \nLast Tetanus Shot:  \nAmbulance Eye Clinic  \nEmergency Room Urgent Care Company Doctor  \nOther:  \nExposure to blood/body fluids? Yes (list exposed below)  \nHospital Admission  \nNo  \nAn exposure is actual contact with blood or body fluids through some route of entry. Route of entry is through the eyes, nose, mouth, or an open area in the skin (i.e. cut, scrape, or wound) .  \nStudent Comments:  \nStudent Signature & Date:  \nStudent Incident Report: Faculty Review  \nDid the Incident result from a lack of training?Contributing Causes:  \nCorrective Action/Training:  \nFaculty Comments:  \nFaculty Signature:  \nDepartment Head Comments:  \nDepartment Head Signature:  \nProvost Comments:  \nProvost Signature:  \nYes  \nNo","cbCaiduGKtzOrEOI","https://ap.wps.com/l/cbCaiduGKtzOrEOI","pdf",4232624,"English","# Student Information\n## Incident Details\n## Medical Treatment and Tetanus\n# Exposure and Student Comments\n# Faculty Review and Approvals\n## Contributing Causes and Corrective Action\n## Signatures and Comments","[{\"question\":\"What information is required for the student incident report?\",\"answer\":\"The form requests the student’s name, program, location, date and time of injury, and a description of the incident including what the student was doing and which body part was injured when applicable.\"},{\"question\":\"How does the report handle delay in notifying the instructor?\",\"answer\":\"It includes a prompt to explain the reason for any delay between the time of the incident and the time the student’s instructor received the incident report.\"},{\"question\":\"What sections collect medical and safety details after an injury?\",\"answer\":\"It records the type of incident, medical treatment (including first responder/urgent care/emergency room options), last tetanus shot, and whether there was exposure to blood or body fluids, with the exposure listed below.\"},{\"question\":\"What is covered in the faculty review portion of the form?\",\"answer\":\"The faculty review section asks whether the incident resulted from a lack of training, lists contributing causes, documents corrective action or training, and collects comments and signatures from faculty, department head, and provost.\"}]","Student Incident Report - Faculty Review | PDF"]