District 20 Halton
980 Fraser Drive, Unit 211
Burlington, Ontario. L7L5P5
(905) 332-1228

Incident Reporting

Have you fallen, been injured, threatened, verbally or physically assaulted?  You need to report it.

Below are three forms (you may need to fill out multiple forms per incident):

1. The Incident Reporting Form - This form is provincially mandated under Bill 157.  If you are witness to an act, or are a victim to an act of violence or aggression, you fill out this form and submit it to your principal.  They MUST act on your complaint and return the form to you with a response.

2. EIR - Employee Incident Form:  This form is work related events or injuries.If you should trip, slip, fall, or injure yourself in any manner at school this needs to be filled out and submitted to your principal and the Joint Heath and Safety Committee. This form is especially important in a WSIB situation.

3. EIR-A - Employee Incident Aggression Form: Must be completed when a student has exhibited violent behaviours that could have caused injury to the employee (whether or not an injury actually occurred).  This form is especially important to track the behaviour of violent students. 

How do we define workplace “Violence”? • Exercise of physical force against a worker ie. teacher, that could cause physical injury. Examples: hitting, shoving, pushing, spitting. • An attempt to exercise force against a worker that could cause physical injury. Examples: threatening behavior, shaking fists, throwing objects. • A statement or behavior that is reasonable for a worker to interpret as a threat to exercise physical force. Examples: verbal or written threats.

Safe Schools Incident Reporting Form (Bill 157) This resource provides direction on how school board employees must handle student incidents that occur at school, at school-related activities or in any other circumstances where the student’s behaviour can have a negative impact on the school climate.

All school board employees need to report to their principal any incident that can lead to suspension or expulsion -
principals are to contact the parents of students involved in these types of incidents.  Staff fill in this form to respond to incidents that have a negative impact on the school climate. These could include racist or sexist comments, vandalism – incidents that are unacceptable in our schools, as well as incidents that can lead to suspension or expulsion.
    Worker Concern Form.  The purpose of this form is to report a potential or existing hazard which you believe presents a risk to the health or safety of individuals in your workplace. When you submit this form to your principal or supervisor they must respond within 7 days to your concern; be it a safety concern / hazard or a health issue.  Please see the Internal Responsibility System (IRS) on the second page of this form.

EIR - Employee Incident Form.  This form must be completed whenever you are injured at work.
It is important to report the injury even if you think the injury is minor, just in case it does turn into something more serious.
Immediately report the injury/illness via this form to the supervisor or principal, in writing where possible, indicating date, time, nature of accident, body parts affected and witnesses.  This form should also be sent to the Joint Health and Safety Committee.

EIRA - Employee Incident Aggression Form:  Must be completed when a student has exhibited violent behaviours that could have caused injury to the employee (whether or not an injury actually occurred). Violent Incident Reporting Act of Violence means threatened, attempted or actual conduct of a person that causes or is likely to cause physical injury. Threatened or actual Acts of Violence to teachers across the province have been increasing over the last number of years. In order to determine trends, the attached form has been developed to allow for the reporting of such incidents. Employees are required to report Acts of Violence using the prescribed form and notify their Supervisor of the situation. Completed forms are to be forwarded to the Health & Safety Office, who will forward it to the Joint Health & Safety Committee representative. All Acts of Violence to an employee, by a student  MUST be reported.

Workplace Violence Poster Violence in the Workplace OSSTF HDSB Violence Prevention Procedure HDSB Violence Threat Risk Assess


The information contained in this website is for general information purposes only. The information is provided by OSSTF and while we endeavour to keep the information correct, we make no representations or warranties of any kind.


980 Fraser Drive, Unit 211
Burlington, Ontario,
L7L 5P5
Phone (905) 332-1228
Fax (905) 335-9220


Students, parents, teachers and education workers all want a strong public education system. We work directly with our members to enhance the students’ experience every day. We work with parents and school boards to safeguard the quality of our public education system.