An incident is an unplanned, undesired event that hinders completion of a task and may cause injury, illness, property damage, or some combination of all three from minor to catastrophic in nature. It is also used to report hazards, near misses, and suspicious activity. Incident reports with respect to matters that fall under the Fair Treatment Policy will be immediately referred to the Fair Treatment Advocate.

The Incident Report Form must be submitted to the HSE Department within 24 hours of the incident occurring, this form can also be submitted anonymously. Forms can be submitted via email to incident@upei.ca, through the UPEI SAFE app, or in-person to AVC 428S. A drop box is located in AVC Main Foyer for after-hour and anonymous submissions.

Please note all serious incidents should be immediately reported to Security Services by calling (902) 566-0384.

​Seek medical attention and/or first aid immediately when injured. All serious injuries should call 911 or UPEI Security (902) 566-0384.

To report an incident:

1. After seeking medical attention and within 24 hours of the incident, complete the Incident Report Form and give to a supervisor or UPEI staff member. The supervisor, staff member or writer of the Incident Report Form will submit it to incident@upei.ca.
   • If you are a UPEI employee and if medical attention beyond first aid was required, submit a completed Form 6 to the Workers Compensation Board (WCB) of PEI immediately. The supervisor will complete and submit Employer's Report - Form 7. The Physician’s Report – Form 8 will be completed by the treating physician and submitted to WCB PEI.
2. The Supervisor will follow up with incident@upei.ca within 72 hours of the incident with an action plan to mitigate the risk of reoccurrence. The Incident Reporting: Supervisor Responsibilities Protocol provides information on what is meant by a minor and major incident, and the specific requirements of the supervisor that must be met once an incident has occurred.
3. HSE will investigate every incident submitted. This may include having a member of the HSE team reach out for follow up or more information from the writer or the supervisor.

If you need assistance with the form and/or the reporting process, please contact the HSE Department at 902-566-0901.

General Forms

• Incident Report
• Anonymous Incident Report
• Incident Witness Statement

Supervisor Forms

• Incident Investigation Form
• Three Point Risk Ranking Scheme and Ranking Matrix
• Root Cause Analysis Form– 5 whys
• UPEI Incident Report Supervisory Responsibilities
• Worker’s Report – WCB Form 6
• Physician’s Report – WCB Form

Serious Injury Reporting

• Serious Injury Report Form
• Serious Injury Witness Statement
• Serious Injury Investigation Form

Right to Refuse Unsafe Work Reporting

• Right to Refuse Unsafe Work Form
• Work Refusal Flow Chart

Please refer to the Health, Safety, and Environment SharePoint site for more information.