Hotel Guest Injury Report Form
Guest Information
Full Name
Room Number
Phone Number
Email Address
Incident Information
Date of Incident
Time of Incident
Location of Incident (e.g., pool, lobby, hallway)
Nature of Injury
Describe How Injury Occurred
Were there any witnesses?
Yes
No
Witness Name(s) and Contact Info
Additional Information
Action Taken/First Aid Provided
Reported to Hotel Staff Member (Name/Position)
Other Comments