Training Injury Report

Submitted by dclewis1 on Wed, 06/24/2020 - 07:22

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

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?