Student Accident Reporting Forms

Student Accident - Injury Reporting Forms
  •   E 3530a Student/Visitor InjuryIncident Report  (This form is also used for visitor injuries)
    • Please complete this form on line.
    • Hit the 'submit' button at the bottom of the form
    • An email copy of the form will be generated to administration, risk management and to the email address you entered.
    • Send any additional updates to  by responding to this email and entering updates in RED type (usually done by nurse).
    • Obtain signatures and BizHub (scan) original to StudentInjuryReports@kpbsd.k12.ak.us (usually done by nurse)
    • This form is not given to the parent or visitor. This is an internal form only.
    • Injury Report Training Powerpoint
    • Student Injury Flowchart (pdf
    •  
  • Accident Claim Form
    • Please complete Part A and give or mail to the parent after each injury.  (Visitors do not receive the Accident Claim Form.)
    • A copy should be attached to E3530a in the nursing files.
  • Cover Letter for Accident Claim form.    
    • This is a letter to explain to the parent about the Accident Claim form.