Heat Illness Reporting Form

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If you experience heat-related symptoms on the job, document it immediately — while the details are fresh. This form takes about two minutes to complete on your phone.

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How to use it:

1. Open the form — date and time fill in automatically

2. Select your station and work location

3. Note the heat conditions and how long you'd been working

4. Check off any symptoms you experienced

5. Record who you notified and what response you received

6. Add any additional notes — staffing levels, no shade, no water, etc.

7. Hit Print / Save PDF to keep a copy, or Copy as Text to paste it into a text or email to your Safety Rep