Job Title *
- Select - Administrative/Professional Dining Services Faculty/Professors Skilled Trades (FM) Landscape Services Custodian (BCSS) Materials and Handling (Stockroom) Health Care Power Plant Police and Parking Coaching and Training (Athletics) Student Employees Student (Non-Employee) Visitor (Non-Employee)
Department *
- Select - Custodial (BCSS) Dining Landscape Maintenance (FM) Alumni Affairs and Development Auxiliary enterprises Business & Finance -- General Center for Disability Services College of Arts and Sciences College of Aviation College of Business (HCOB) College of Education College of Engineering and Applied Sciences College of Fine Arts College of Health & Human Services MARCOM Merze Tate College Construction/Remodel Shop Dean of Students Kalamazoo Autism Center Intercollegiate Athletics Libraries Logistical Services Multicultural Affairs Office for Sustainability Office of Information Technology Office of the President Police and parking Power Plant Provost Research and Sponsored Programs Residence Life/Student Affairs Sindecuse Health Center Student (non-employee) Transportation (Garage) Visitor WMUx
Location of Incident *
- Select - Ackley Hall V I Alliance Senior Services Arcadia Flats (new) Bella Vita Cafe' (at CHHS) Bernhard Cafe' (at Bernhard Center) Bernhard Center Bill Brown Bobb Stadium Britton Hall V I Bronco Mall Brown Hall Burnham Burnham Dining Services Cafe' 1903 (at VDC) Campus Services Building Campus wide Center for Disability Services CDS Chemistry Building Coating Pilot Plant College of Aviation (Battle Creek) College of Health and Human Services College of Engineering and Applied Sciences Dalton Center Bistro 3 Davis Dining Davis Hall Draper Dining Draper Hall Dunbar Ebert Field Eicher V II Eldridge V III Ellsworth Everett Tower EWB Faunce Student Services Bldg Fetzer Center Flossie's Cafe' (at Sangren Hall) French Hall Friedmann Hall Fox Hall V III Garneau V II Gilmore House Gilmore Theater Complex Goldsworth Valley Apartments Grand Rapids East Beltline Grand Rapids Downtown Hadley Hall V I Haenicke Harrison Hall V III Harvey V II Haworth College of Business Henry Hall Heritage Hall Hyames Field Intramural Fields Kalamazoo Autism Center Kanley Chapel Kanley Track Kendall Center Knauss Hall Kohrman - Central Korhman - North Korhman - South Lawson Arena Lee Honors College Lefevre Hall V II MGREE Miller Auditorium Miller Plaza Montague House Moore Hall Oakland Gym Off campus Office for Sustainability Other (Please Specify) Outside Parking Services Garage Parking Lot Parking Services Parkview Cafe' (at CEAS) Physical Plant Plaza Cafe' (at Sprau Tower) Power Plant Presidents Residence Press box Public Safety Read Field House Richmond Center RCVA Rood Hall Salt Dome Sangren Hall Schneider Cafe' (at Schneider Hall) Schneider Hall Seeyle Center Seibert Admin Bldg Shaw Theatre Shilling Hall V I Siedschlag Hall Sindecuse Health Center Softball Field South pump house Spindler Hall Sprau Tower Stadium Drive Apt Stinson V III Student Rec Center Student Center (new) The Oaklands Trimpe Unified Clinics University Arena University Computer Center UCC Unknown Upholstery Shop Valley I Valley II Valley III Valley Dining Center Vandercook Waldo Library Waldo Stadium Walwood Hall Welborn Hall West Hills AC Western Heights East Western Heights West Western View Apartments WMU Bookstore Wood Hall Zhang Legacy Collection Zimmerman
Where did the injured party receive medical treatment?
Sindecuse Health Center Battle Creek Ascension Borgess Bronson Westside Family Medical Other
What body part or parts were affected? *
You may choose more than one body part. (Hold down the Ctrl key to select multiple choices.)
Abdomen Ankle Arm Back Back Lower Brain Buttocks Cheek Chest Digestive System Ear (not hearing) Elbow Eye (not sight) Face Finger Foot Forearm Hand Head (not brain) Heart Hip Internal Kidney Bladder Intestine Knee Leg Lungs Mouth (not teeth) Neck Nervous System Nose (not sense of smell) Other (please describe in "what happened") Pelvic or Groin Reporting Near Miss Only Ribs Scalp Shoulder Skull Spine Tooth or Teeth Thigh Throat Thumb Toe or Toes Tongue Unknown Wrist
Side of the Body *
Which side of the body did the injury occur?
What could be done to prevent this kind of incident in the future?
Supervisor's WMICH Email *
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