4828 S Pearl st shoms@nv.ccsd.net 702.855.5558

Risk Management Forms

Non Health Office Report

Non Health Office Treatment Report

Report used for injuries to students which are not treated in the Health Office. This is the after hours accident form.

 Witness Statement

Form used to gather additional facts regarding an injury.

Request for Incident Report

Request for Student Health Office Records.

Visitor Injury/Property Damage Report

Report of a visitor injury or property damage while on CCSD campus.

Transportation Student Injury Report

Report used by bus drivers for injuries that occur on the school bus.

Printable User Agreement

Print this form to submit to SHOMS for Health Master Access. Rev 12/2017