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Incident/Accident Report

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$70.40
QuantityPrice
1 – 4$70.40
5 – 9$61.50
10 – 14$52.70
15 +$43.60
SKU: CFS6-18/2
$70.40

UPDATED 2023

Document the events of any incident/accident involving a resident, employee, visitor or other person to provide information and statistics for the Quality Assurance Committee/Safety Committee and, if necessary, for litigation investigations.


Download a sample today!

  • Size:  8 ½” x 11”
  • Paper:  2-part carbonless snap set; white original, yellow duplicate
  • Copy:  Each part prints black ink one side
  • Punching:  3-holes side
  • Packaging:  100 per pack

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