EmailMeForm
ELIZABETHAN CATERING INJURY REPORT FORM
Please complete this online, as soon as the injury occurs! All segments of this form need to have an answer. Thank you!
Date of Injury
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Time of Injury
*
Your Name
*
Mobile Number to contact you
*
Please describe EXACTLY what happened to you, and what part of you is/was injured.
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Did you need an Ambulance?
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Yes
No
Did you need a visit to your Doctor or Emergency Department of the local hospital?
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Yes
No
Are you going to provide us with a Doctor's Note, relevant to your Injury?
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Yes
No
Have you filled out the correct Injury Form and handed it in?
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Yes
Not yet
Not Neccessary
Anything else to add, including a recommendation to avoid an injury like yours, from happening in the future. Avoidance in the future is important to us!
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