County employee: Complete this form at the time and site of the injury and send it immediately to Risk Management. If the citizen requires medical care, also call Risk Mgmt. Take photos whenever possible.

Risk Mgmt: Office: (520) 432-9720
Fax: (520) 432-9716

I. Incident
II. Citizen Information
III. Incident and Injury Description
IV. First Aid
V. Transport
VI. Statement(s)
VII. Report