2026-06-12_CanwideSteel_FirstAidRecord

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FIRST AID RECORD

OHS PROGRAM – RECORD OF FIRST AID TREATMENT

FORM #FA-01 | REV. 01

Worker & Incident Details

Sequence Number

First and last name

Occupation

Date of injury, exposure, or illness

Time of injury, exposure, or illness

AM / PM

AM PM

Initial reporting date and time

AM / PM

AM PM

Follow-up report date and time

AM / PM

AM PM

Initial report sequence number

Subsequent report sequence number(s)

Injury & Treatment Details

Description of how the injury, exposure, or illness occurred (What happened?)

Description of the nature of the injury, exposure, or illness (What did you see? [signs & symptoms])

Description of the treatment given (What did you do?)

Witness Name #1

Witness Name #2

Arrangements & Handouts

Arrangements made relating to the worker (return to work/medical aid/ambulance/follow-up)

Provided worker handout

Yes No

Discussed recommendations for return to work

Yes No

Sent form to medical aid

Yes No

REVIEW & SIGN-OFF

PATIENT / WORKER

Name

Date

SIGNATURE

Select Name to Sign

FIRST AID ATTENDANT

Name

Date

SIGNATURE

Select Name to Sign

RECENT SUBMISSIONS (LAST 24 HOURS)

No records have been submitted in the last 24 hours.

CANWIDE STEEL Ltd. · OHS PROGRAM