Instructions
Incident/Injury Report
(JFS 01299)

1.    Print 3 copies of the form.

2.    Complete and sign each copy within 24
       hours of an incident or injury. 

3.    Keep one copy for your records. 

4.    Give one copy to the parent or
       caretaker.

5.    Return one copy to your Home Provider
       Specialist by either:
       Mail:     Job and Family Services
                  222 East Central Parkway
                  Cincinnati, Ohio 45202
                  Attn: Child Care Provider Program

       Fax:      (513) 946-1102

Be sure to write your Home Provider Specialist's name on any forms you mail or fax. 

Click here for form