Lab Incidents and Lab Incident Report Form

All laboratory incidents (spills, leaks, cuts) must be reported to the faculty member, the department head, and to Environmental Health and Safety (EH&S) by phone at: 413-545-2682, and through completion of the Lab Incident Report Form.  EH&S will report to the department to investigate upon notification or if called by emergency personnel or University Health Services. If the incident caused an injury, a Notice of Injury (NOI) form must also be filed with the UMass Amherst Department of Human Resources (HR).

Lab Incident Report Form

Complete the attached Lab Incident Report Form. (The form is also in the Laboratory Health and Safety Manual/Chemical Hygiene Plan Appendix F.) Complete the form within 48 hours of the incident. Please email the completed form to Christine Rogers car@ehs.umass.edu. EH&S will investigate the incident and send a report to the supervisor, department chair and department lab safety coordinator.

Notice of Injury Report Form

If the incident resulted in an injury and the injured party is a UMass Amherst employee, an NOI must also be filed with UMass Amherst HR. Contact the HR Worker's Compensation Specialist at: 413-545-6114, and ask for an NOI form. The NOI must be completed by the injured employee and signed by his/her supervisor. Return the NOI to HR within 48 hours of the incident.

Also refer to Report an Injury.