Forms

There is various forms needed for Health and Safety. Just follow the links to the forms you require. Any additional questions, please contact:

Jaime Russell
Health & Safety/Plant Services Officer
Phone:  613-735-1032 Extension 343
E-mail: jrussell@rccdsb.edu.on.ca

FORMS

• Employee Incident/Accident Report
• Functional Abilities Form
• Treatment Memo (to be taken to the hospital)

Workplace Safety & Insurance Board Forms (W.S.I.B.)

• W.S.I.B Treatment Memorandum (To be taken to hospital)
• W.S.I.B. Worker Forms
• W.S.I.B. Employer Forms
• W.S.I.B. HealthCare Practitioner Forms
• W.S.I.B. Functional Abilities Form

STUDENT FORMS

• Student Accident Report Form PDF

CARETAKER FORMS

• Water Flushing Form
• Sanding, Salting, Snow Removal Form
• Emergency Lighting Monthly Report
• Eye Wash Check Form
• Fire Alarm Check Form
• Ladder Inspection Checklist
• Monthly Exit Lights Record Checks
• Monthly Fire Extinguishers Record Checks
• Record of Inspection Check During Absence from Building Form
• Custodial Supply Order Form
• Community Use of Schools Timesheet
• Report of Overtime