Near Miss and Employee Incident forms have been combined and are now on DocuSign. Please follow the link to DocuSign for completing the forms.

Employee/Supervisor Forms:

Incidents must be reported within 24 hours. If medical care is needed please let the designated medical provider know this is a work related injury. 

Incident Report for NDSU Employees/Near Miss Report

Instructions for completing the form

Non-Employee Forms:

Injured students or visitors may seek medical care if they feel it is necessary at the medical provider of their choice. Non-employee incident report must be submitted to the Safety Office within 24 hours of incident. Get the name and address of the injuired person and the hospital if possible. 

Incident Report for Non-Employees/Property Damage

For questions contact Lois at (701) 231-9587.

• Quick Reference Guide for Workers
• Workforce Safety and Insurance (DMP) Law - 65-05-28.1
• Designated Medical Provider List