Work Related Accidents OR HAZARD

Form

Please fill out the report at the bottom of the page. Once received, a member of our team will contact you within 2 business days. This is a completely confidential process. You must also report the event to a representative of the producer, even if you are able to continue working.

THERE ARE NOW 3 CATEGORIES OF SITUATIONS:

1. A dangerous condition is defined as a risk that could affect mental and/or physical health (e.g. working on a roof, near the edge of a roof);
   
   
2. A near-miss is defined as an incident that has occurred and did not result in injury or illness but is liable to do so (e.g. slipping on a puddle of water on the floor but regaining balance without falling);
   
   
3. An accident is defined as a specific incident that resulted in injury or illness. The accident may or may not require first aid or medical attention (e.g. suffering a sore back while handling lighting equipment, which may not require treatment). The term also includes psychological disorders and occupational diseases.

reference Documents 

• CNESST Guide - AQTIS 514 IATSETechnician accident (In French only)
• Secouriste sur un plateau

• Accident register for first aid attendants and first aiders

• Form - Register accidents incidents first aid

Important: Completing this form does not constitute filing a CNESST claim.