DISTRICT
1.1E15.2
Revised: June 14, 2002
Environmental Health and Safety Department
533-8623

1. STUDENT OR VISITOR:
1. The Medical Emergency Report must be completed within 24 hours of the incident.
2. The completed report must be submitted to the student’s instructor, an administrator, supervisor or a faculty/staff member for signature.
3. The signee must retain one copy, give one copy to the affected person, and send the original to the Environmental Health and Safety Department at MS 1016.
4. If the student or visitor chooses to seek professional medical treatment for the incident, the treatment is the financial responsibility of the affected person.

Note: CCS students who are not medically insured have the option of purchasing a Student Injury and Sickness Insurance Plan at the time of enrollment (eligibility requirements must be met).

5. The affected person has the option of filing a Tort Claim for damages if he/she believes that CCS was responsible for the cause of the incident. The affected person should contact the Business and Finance Office at 434-5275 for a State of Washington Tort Claim form. The completed form should be sent to the Business and Finance office (MS 1006) where it will be submitted to the Division of Risk Management in Olympia, Washington.
2. Injuries and illnesses that occur at off-campus sites, but during approved college activities and functions, should also be reported on the form.
3. All CCS employees should be prepared to assist students and visitors in the reporting of an incident and should not admit liability or fault.