ACCIDENT REPORTING FORM

Please note that this page looks a little different than the Student Accident Form page as we’ve migrated our reporting to Google Forms and have made it inclusive of all accident reporting. To report an accident, please follow the link to the Accident Reporting Form.

Click to find out more about first aid and medical follow-up policy,  accident reporting, and covering the cost of medical care.

What to do when an accident occurs that causes personal injury? First Aid First! Perform necessary first aid/seek medical attention as directed by the situation or SDS in case of chemical exposure. Call x5555 for assistance and transport. Students doing unpaid work: Campus Safety can transport you to Cooley-Dickinson Emergency Department year round and the Schacht Health Center during the academic year. Students injured during unpaid work that seek off campus medical attention should go to the Emergency Department as there are no upfront costs. Paid workers: Campus Safety can transport you to Cooley-Dickinson Emergency Department or Cooley Dickinson Urgent Care year round and can transport student workers to the Schacht Health Center during the academic year. Covering the Cost of Medical Care Students doing unpaid work: Students should seek financial assistance by applying for emergency funds through the Dean of the College. You should keep all receipts for medical treatment (e.g. copays) as documentation will be required. Paid workers: Medical expenses for an injury while working at Smith are reimbursable through worker’s compensation. Please state to any healthcare provider that this treatment is covered by Smith College worker’s compensation. You should keep all receipts for medical treatment (e.g. copays) as documentation will be required. Accident Reporting Students doing unpaid work: Complete the Accident Reporting Form at https://www.science.smith.edu/safety/accident-reporting-form/ Paid workers: Complete the Accident Reporting Form at https://www.science.smith.edu/safety/accident-reporting-form/ and the First Report of a Work-Related Accident for HR at https://www.smith.edu/sites/default/files/media/Documents/HR/First-Report-of-Injury.pdf

First Aid and Medical Follow-Up Policy

All accidents requiring first aid must be reported as soon as possible, ideally within 24 hours. Immediate professional medical follow-up is required if there is exposure to any mucus membranes (eyes, nose, mouth), if the SDS indicates medical follow up is necessary, and/or if the injured person is unsure of what they may have been exposed to (e.g. a person gets exposed to something from a bottle with a faded label so they’re uncertain of the contents). When the chemical/biological agent is known, it is critical for the exposed person to take the SDS for the material with them when seeking medical attention. Campus Safety will transport to Schacht Health Services or Cooley Dickinson ER as appropriate.

Accident Reporting

The College is concerned about the health and safety of its students, faculty, staff and visitors and should be informed of any injuries that occur while someone is at Smith. We ask that anyone injured during work or academic activities related to the Clark Science Center or Art/Theatre, completes the Accident Reporting Form.

Students working for an hourly wage or stipend and faculty/staff should also submit the First Report of Work Related Accident. When the employee has completed the upper section of the First Report of Work Related Accident form, they should give it to their supervising faculty/staff member to provide any additional comments.This form, receipts for reimbursement (including copays), invoices/bills for treatment, and questions regarding a worker’s compensation claim should be directed to Human Resources’ Amy Smith (asmith13@smith.edu, 413-585-2289). Completed forms should be scanned and sent to Amy Smith asmith13@smith.edu, cc’ing hr@smith.edu and mrakas@smith.edu.

The information gathered from these forms will be used to assess accident prevention programs at Smith.

Covering the Cost of Medical Care

Do not refuse medical care because of the cost. The College has resources to help cover the cost of medical care due to injuries. 

Medical expenses for an injury while working at Smith are reimbursable through worker’s compensation. Please state to any healthcare provider that this treatment is covered by Smith College worker’s compensation. Campus Safety can transport you to Cooley-Dickinson Emergency Department or Cooley Dickinson Urgent Care year round and can transport student workers to the Schacht Health Center during the academic year.

Students who are injured during college-related activities, but not while employed by the college are not eligible for worker’s compensation but should seek financial assistance by applying for emergency funds through the Dean of the College. Campus Safety can transport you to Cooley-Dickinson Emergency Department year round or to the Schacht Health Center during the academic year. Students injured during unpaid work that seek off campus medical attention should go to the Emergency Department as there are no upfront costs.

Whether you are using worker’s compensation or emergency funds through the Dean of the College, you should keep all receipts for medical treatment (e.g. copays) as documentation will be required.