Accident and Illness Report - Deluxe

Form Template

This Accident and Illness Report from Deluxe® Mobile App allows for the collection of data pertaining to any work injury or illness, whether onsite or offsite, in order to create an incident report.

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In the case of injury, the form also collects information about the nature of the injury, the location of the injury, the cause of the injury, and the victim of the injury. A way to gather prompt and standardized information, this form makes sure injuries and illnesses can be formally recorded for future reference. In the case of an occupational injury by an employee, use this app to report this workplace injury for health and safety purposes. As a supervisor of employees, use this app to perform an accident investigation of incidents that require medical attention.

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“I’m not a tech guy and I was able to pick this thing up in probably an hour, and actually start to build apps. I’ve done them over lunch when I’ve gotten frustrated with a process that didn’t exist in our company. So for non tech people who’ve got a problem, the support here is awesome and I’d recommend it to anybody, not just in our industry.”

Dave Kramer, PennLine Service

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