Injury Response Workbook
The Injury Response Workbook
A customizable 4-step system for small-business owners
Your employee just got hurt. Now what?
An employee injury can be stressful—but trying to figure out what to do while it is happening is even harder. This workbook helps you create a simple, organized employee injury response system before you need it. Based on the 4-step framework from the Systems with Sonja video, this workbook gives you practical forms you can customize for your business:
What’s Included — 7 Customizable Forms
1. Emergency / Immediate Response Checklist
A step-by-step checklist for what your team should do when an employee reports an injury.
2. Management Response Checklist
Helps managers know their responsibilities, who to notify, and what needs to happen next.
3. Employee Incident Report Form
A structured form to capture the who, what, where, when and why of the incident.
4. Witness & Scene Documentation Form
A place to document witness observations and relevant information about the incident scene.
5. Medical & Insurance Contact Log
Track contacts, communications, claim information, and related documentation.
6. Work Restrictions & Modified Duty Form
Document work restrictions, modified-duty considerations, responsibilities, and follow-up.
7. Follow-Up Tracker
Keep outstanding items, owners, deadlines, documentation, and next steps organized after the initial incident.
BONUS: Make It Your System Worksheet
Customize the process for your business by adding your contacts, responsibilities, backups, and next steps.
Why You Need It
The goal isn't to predict every possible workplace injury. The goal is to make your response clearer, more consistent, and less dependent on one person's memory. Work through the workbook when things are calm. Add your business's contacts, people, and procedures—and then keep your completed process somewhere your team can access it. Instant digital download. Customize it for your business.
Important Disclaimer
This workbook is provided for general informational and educational purposes only. It is not legal, insurance, medical, or HR advice and is not a substitute for your attorney, insurance professional, workers' compensation carrier, or other qualified advisor. Workers' compensation requirements and procedures vary by state and circumstance. Review, customize, and approve the materials with the appropriate professional before using them in your business.
Business Infrastructure for Women Entrepreneurs