Injury Report Please enable JavaScript in your browser to complete this form.Injured Person (Name): *Address: *Phone No.: *Email: *EmployeeContractorHomeownerTenantOtherDate Reported to you: *Location of Occurence: *Witnesses: *Describe how the accident occurred: *Photographs of area of incident attached to this report?: *YesNoIf no, explain why not: *Describe injuries: *Describe corrective action taken to prevent recurrence of this accident: *Print Name: *Date: *Report Taken by: *Signature: *MessageSubmit Injury Prevention Programs Ventura County HOA Management 805-628-2900