69´«Ã½

An incident is an unplanned, undesired event that hinders completion of a task and may cause injury, illness, property damage, or some combination of all three from minor to catastrophic in nature. It is also used to report hazards, near misses, and suspicious activity. Incident reports with respect to matters that fall under the will be immediately referred to the Fair Treatment Advocate.

The must be submitted to the HSE Department within 24 hours of the incident occurring, this form can also be submitted anonymously. Forms can be submitted via email to incident@upei.ca, through the 69´«Ã½SAFE app, or in-person to AVC 428S. A drop box is located in AVC Main Foyer for after-hour and anonymous submissions.

Please note all serious incidents should be immediately reported to Security Services by calling (902) 566-0384.

​Seek medical attention and/or first aid immediately when injured. All serious injuries should call 911 or 69´«Ã½Security (902) 566-0384.

To report an incident:

1. After seeking medical attention and within 24 hours of the incident, complete the and give to a supervisor or 69´«Ã½staff member. The supervisor, staff member or writer of the Incident Report Form will submit it to incident@upei.ca.
   • If you are a 69´«Ã½employee and if medical attention beyond first aid was required, submit a completed to the Workers Compensation Board (WCB) of PEI immediately. The supervisor will complete and submit . The will be completed by the treating physician and submitted to WCB PEI.
2. The Supervisor will follow up with incident@upei.ca within 72 hours of the incident with an action plan to mitigate the risk of reoccurrence. The provides information on what is meant by a minor and major incident, and the specific requirements of the supervisor that must be met once an incident has occurred.
3. HSE will investigate every incident submitted. This may include having a member of the HSE team reach out for follow up or more information from the writer or the supervisor.

If you need assistance with the form and/or the reporting process, please contact the HSE Department at 902-566-0901.

General Forms

Supervisor Forms

• – 5 whys

Serious Injury Reporting

Right to Refuse Unsafe Work Reporting

Please  for more information.