Report of Student Injury and First Aid form

<<WISHeS Injury and Illness Protocols

The following form, Report of Student Injury and First Aid form was developed in conjunction with the Injury and Illness Protocols.  This two-paged form allows for more detailed documentation of the injury and subsequent first aid provided to the student.  This form can be used as the districts Accident Reporting Form, if the district does not already have one.  This form can be used as an alternative to the Department of Public Instruction Student Accident Report, which can be found online at http://dpi.wi.gov/files/forms/doc/pod1945.doc.  It is also recommended that some kind of written documentation be sent home to the parent(s)/guardian(s) following an accident or injury at school.

Report of Student Injury and First Aid form

 

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