Incident and Accident Reporting
Timely reporting and thorough investigation of incidents or accidents are critical to preventing repeat occurrences. An accident is an unplanned event that causes personal injury or property damage. An incident is an unplanned, or ‘near miss”, event that could have caused personal injury or property damage.
The tab on the left contains the complete "Incident and Accident Reporting and Investigation Policy" 
, which provides details on responsibilities, reporting and investigation. To facilitate
the reporting of incidents or accidents, please use the on-line reporting forms below,
which allow you to save the report and email it to the appropriate LSUHSC departments.
Quick instructions:
- Ensure you have the latest copy of Adobe Reader on your computer. http://get.adobe.com/reader/
- Download the applicable report form to your computer desktop.
- Complete the downloaded/saved form.
- Email the completed form to the appropriate email address:
All incidents and accidents must be reported within five calendar days; vehicle accidents must be reported within 48 hours.
Note that in addition to the guidance below, if any accident results in an Emergency Medical Service response, contact University Police. University Police should also be contacted for vehicle accidents if the accident involved an LSUHSC-owned vehicle, occurred on LSUHSC grounds, or involved injury or death.
Except in the cases of visitors, contractors, and students outside of the classroom as described below, University Police does not need to be contacted for minor accidents.
If you have any questions or need technical assistance, contact EH&S at 568-6585 or Safety@lsuhsc.edu.
On-Line Reporting forms:
- For an employee incident or accident, supervisors will complete and submit the DA 2000 form , to include determining the root cause of the incident or accident
- For a student incident or accident in the classroom/laboratory, instructors will complete and submit the DA 3000 form
- For a student incident or accident outside of the classroom/laboratory, notify University Police, who will visit the scene and complete and submit the DA 3000 form
- For a incident or accident involving a visitor or contractor, notify University Police. University Police will visit the scene and complete and
submit the DA 3000 form
- In the event of an automobile accident while driving on official business, complete the Auto Accident Report DA 2041 form and submit within 48 business hours (2 business days). Alternatively, to expedite
submittal if the DA 2041 has been completed by hand, it may be scanned and emailed
to DA2041@lsuhsc.edu and 6410StateofLouisiana@sedgwickcms.com. The DA 2000 form is not required for automobile accidents
Other Reporting forms:
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For employees that incur medical expenses as a result of a work-related accident, supervisors shall complete the DA1973 form and email a scanned copy to the Human Resources Department at HRMFMLA@lsuhsc.edu.