CES Student Accident Report
This report will be sent to your principal after submitting.
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Staff Name *
Date of Incident *
MM
/
DD
/
YYYY
Student Last Name *
Student First Name *
Was parent contact made? *
Location of Accident *
Description of accident: Please include location, how the accident happened, and what immediate actions were taken *
Kind of injury: Please include degree of injury and any medical treatment administered. *
List any witnesses *
Please list any damages *
Submit
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