UBC Centralized Accident / Incident Reporting System (CAIRS)

Instructions

• Please answer the below questions to start your submission
• These questions will determine the questions that show up on the Incident/Accident form
• The incident form does not time-out, so you may take as long as required to fill in the information
• If you close the form you will lose what you entered
• You may need employment and salary information to complete the form, make sure you can obtain this information from your department's administrator
• Your information is collected under the authority of section 26(c) of the Freedom of Information and Protection of Privacy Act for the sole purpose of investigating your incident/accident report. It will be kept confidential and will only be disclosed within UBC on a ‘need to know’ basis or as otherwise authorized by law.

Person Injured / Affected Type:	Staff Faculty Paid Student Practicum/Clinical Placement Student Other Student Visitor/Volunteer/Visiting Student Contractor
User Filling in Form (You):	Supervisor Person Injured/Affected (WorksafeBC 6A form) Witness/Person Reported To (Other Students, Visitors, Contractors only)
Employee Campus Affiliation:	Vancouver Okanagan Other UBC Location
Severity:	Incident Only (near-miss, minor injury, or property damage) Medical Treatment (visit doctor, no days off) Time Loss (days off work, excluding incident day)
Type of Claim:	No injury An injury An occupational disease A repetitive/gradual onset injury

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