When and How to Report
Report to Florida Atlantic University College of Medicine Self-Insurance Program care of the University of Florida J. Hillis Miller Self-Insurance Program
Immediately upon the occurrence of a potentially reportable event (as soon as the patient's needs are addressed), notify the Self-Insurance Program by calling the Gainesville, FL administrative offices:
Gainesville, FL |
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UF Self-Insurance Program |
DO NOT USE E-MAIL TO MAKE REPORTS!!
During business hours, you will be connected to a SIP coordinator who will take the information and provide guidance. After normal business hours, leave a message as instructed by the voice mail and a coordinator will return your call.
Information we will need to know:
- Name, sex, and age of patient
- Medical record number
- Date of admission and admission diagnosis
- Date, time, and location (e.g. inpatient facility, outpatient clinic) of the occurrence
- Brief description of the occurrence with the names of the involved individuals and witnesses
- Description of the injury, the treatment provided, and the name(s) of the physician(s) notified
Residents must also notify their Attending and department residency program director. Students/Other Staff members must notify their supervisors.
