Incident Report Form

For both employees and visitors, use this form to report accidents, injuries, medical situations, and criminal activities. This report should be completed within 24 hours of the event.

Upon submission:

  • Visitors will automatically receive an emailed copy of this report.
  • Employees will automatically receive an emailed copy of this report and our Workers’ Comp Form to print, which can be presented to a treating medical facility if necessary. Additionally, employees will automatically receive a text message with GPS links to the three closest Emergency Rooms (ERs).

Starting Monday, April 8th through the end of September, the Illinois Department of Transportation (IDOT) will begin their road resurfacing project along Waukegan Road from Lake Cook Road to Half Day Road (IL 22). Please allow additional travel time to our hospital during the construction. Learn More: Waukegan Road Resurfacing Project