Oregon Dept. of Forestry. Incident Analysis Form

Oregon Dept. of Forestry

Incident Analysis Form

ODF SAIF 801

CONTACT INFORMATION:

• Dan Jones, HR Generalist• Oregon Department of Forestry• Office: 503-945-7253• Cell: 541-619-8609• Fax: 503-945-7404• Email: djones@odf.state.or.us

New in 2013!

* Has information for injuries

(Great resource for incident business practices for DNR resources)

IIR Form

Initial Incident Report

SRI FormFire supervisor must complete within 3 days.

IIR Form is required along with this form.

WA State DNR Injuries Information

* On-the-job injuries are covered by WA ST Labor & Industries (L&I)

* Medical expenses are covered by providers completing the form when services are provided

* Failure to use the L&I process could result in injured employee paying costs out of pocket without reimbursement

WA ST L&I Form

* Medical Providers have & initiate

* Form/process thru L&I must be followed. For help, call: 360.902.1061 or 800.562.6010

SF137 Form

(Vehicle AccidentReporting Form)

Needed if an employee is injured in a vehicle accident

Agency Specific Clarifications

Call Us! DNR’s Incident Business Manager

(Presenter at Workshop)