Student injury report (GRS-1579)

Description

This report is completed by school personnel immediately after a severe student injury and a copy is then submitted to the State Child Injury Prevention Program. An injury is considered severe if it requires the loss of a half day or more of school or warranted medical attention or was required to be reported by district policy. The form includes child's name, parent's name, district name and number, and school name and number; student's sex, birthdate, and grade; accident's date and time; number of days absent; action taken by school and parent; nature of injury; area affected; contributing factors; period; surface; location; activity; equipment; injury description; signature of person making report; title code; and principal's signature. The state's copy is retained for five years.

Retention and Disposition

Retain for 7 years, and then destroy records.

Appraisal Value

Appraisal