Risk Management - Injury & Incident Reporting - Report a Non-Employee Injury/Incident

Extension employees should submit all non-employee injury/incident reports using an Extension-specific SharePoint workflow.

• UW-Madison Risk Management requires that all high-risk NON-UW-Madison employee injuries/incidents be reported.
• Extension Employees should follow the High-Risk Injury/Incident Response workflow in the case of a high-risk incident. 
• The report must be filed within 48 hours of the incident.
• Extension has its own workflow on SharePoint for submitting these reports directly to Risk Management.
• Follow the instructions below for completing a report and submitting to Risk Management.

Guidance for Submitting

• Follow the high-risk injury/incident response workflow and submit a report if one of the following occurs as a result of Extension Programs, Events, or Activities.
• A bodily injury occurs to an Extension Volunteer, Extension Program Participant, or third party;
• Property damage is incurred by a third party;
• An injury/incident occurs that could be classified as "high risk."

1) Complete the Non-Employee Injury/Incident Report Form

• Download the Non-Employee Injury/Incident Report form to your local computer. Complete the report.
• Note: If you have printed copies that you have filled out by hand, you can scan them into PDFs. 

2) Submit the Report Form through SharePoint

• Go to the Extension Injury/Accident Reporting SharePoint Site.
• Click the "Draft Report" button to prepare your report for submission. Save it. You may save and edit it as needed. 

• Complete these fields for your submission:
• Record Title: Append [First Name] [Last Name] [Date] to the template document name
• E.g. UW-Madison-General-Non-Employee-Accident-Injury-Incident-Report - Nathaniel Shay 2019.11.04
• Incident Type: Select whether it is a non-employee injury/incident, near-miss, or vehicle accident report. 
• Description: Include a brief description of why you are submitting the report. 
• Incident Date: Date the incident documented in the report occurred.
• 4-H Accident?: Select whether the incident was 4-H related (Yes/No).
• Upham Woods Accident?: Select whether the incident was Upham Woods related (Yes/No).
• Volunteer Related: Select whether the incident involved a volunteer (Yes/No).
• Immediate Supervisor: Your immediate supervisor's email.
• Institute Director: Your institute director's email.
• Attach Completed Report: Upload the completed report as an attachment. 
• When you are ready to submit, click on the "My Reports" button. Find your Report. 

• Click "Send to Risk Management".

• If you have any questions related to the report form, please contact the Office of Risk Management (608) 262-0379.
• If you have any questions related to the Extension SharePoint Workflow, please contact the Extension Help Desk (all tickets will be routed through DoIT Help Desk).