Training Injury Report

Submitted by dclewis1 on

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

Please contact with any issues or questions.

Indicates required field
Name of Person Reporting Injury

Injured Firefighter Or Rescue Personnel Information

Injured Firefighter Or Rescue Personnel Information
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?
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?