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What’s New
Events
Procurement Opportunities
Township
About Us
Elected Officials
Board of Trustee Meetings
Staff
History
Services
Police
Police/Crash Reports
House Checks
Impounded Vehicles
Paying Citations
Report Crime/Tip Line
Search County Court Records
Franklin County Sex Offender Registry
Wanted Persons Database
Ohio Attorney General
File a Complaint or Compliment
Fire
Fire Department History
Fire Stations
Fire Inspection, Prevention & Education
Fire Permit Application
Fire Permit Fee Structure
Fire: Frequently Asked Questions
Cemetery
Mifflin Cemetery
Riverside Cemetery
Cemetery Pricing
Sell Back Graves
Rules and Regulations
Public Service
Report a Roadway Issue
Code Enforcement
Illegal Dumping
Report a Code Violation
Stormwater Management
Residential Building Permits and Zoning
Trash, Recycling and Yard Waste Collection
Safety and Prevention
Addiction Resources
Car Seat Inspection
CPR Training
Community Paramedicine
Women in Crisis
Contact Us
Careers
HR – Investigating Manager’s Accident Form
HR – Investigating Manager’s Accident Form
HR: Investigating Manager’s Accident Form
Investigating Manager’s Name
*
Full first and last name
Date of Report
*
Location where the injury occurred
*
Is there property damage
*
Yes
No
Does the scene/vehicle pose additional safety concerns?
*
Yes
No
Description of vehicle and/or property damage, if applicable:
Details of the investigation:
Did the investigation determine that the employee violated safety procedures?
Did the investigation determine that the employee violated department and/or township policy?
What are you recommendations or what actions have been taken to avoid similar incidents in the future, if applicable?
Does the scene/vehicle pose additional safety concerns?
*
Yes
No
If yes, provide details
*
Additional comments
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