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Get and Sign IncidentInjuryIllness Reporting Form Ohio Department of Education
Names of staff witness/es Child s gender Who provided first aid Date of first aid How many staff members were supervising this group Family Contacted How many children were there in this child s group Date family were contacted Age of child-group that child was assigned to at the time of the incident/injury/illness Number of hours child in your care per day Young Infant less than 12 months Infant 12 -18 months Preschooler 3-5 years not in school Type of Injury check all that apply Nosebleed...
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