Training Injury Report

The purpose of this form is to Report Injuries during training to the North Carolina Office of the State Fire Marshal.

Please contact Anthony.Killough@ncdoi.gov or Devin.Cockrell@ncdoi.gov with any issues or questions.

Indicates required field
Injured Firefighter Or Rescue Personnel Information
Classify the injury from the following categories
Was this North Carolina Fire and Rescue Commission (NCF&RC) certification class?
Is instructor certified as a General Level II instructor?
Was this class taught through a NCF&RC delivery agency?
Was there damage to injured personnel's protective equipment?
Was the injured firefighter wearing a SCBA at the time of the incident?
Was a Safety Officer assigned at the time of injury?