Epinet Injury and Exposure Report Form



EPINet/Access downloadable report forms 

Note: The forms below are in English and designed for use chiefly in the United States. To access EPINet Needlestick and Blood and Body Fluid Exposure Report forms in other languages, and/or designed for use in other countries, please click here.

 SOI Needlestick and Sharp-Object Injury Report form

 BBF Blood and Body Fluid Exposure Report form

 PEF Post-Exposure Follow-Up form

Notes about downloading EPINet forms:

  • EPINet forms can be freely copied and distributed for non-commercial use in healthcare facilities. The copyright statement must be included on all forms.

  • The downable forms on this page are in Adobe Acrobat format; Adobe Acrobat Reader is necessary to view them. Click on the "Get Acrobat Reader" button, below, and follow the instructions to obtain the latest version from the Adobe Acrobat Reader website.

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