Welcome to your Online Healthcare Liability Event Reporting tool!

Currently Under Development – PLEASE DO NOT USE

IMPORTANT … Use of this online reporting method is restricted to our covered healthcare providers, participants, and their support staff. If you are not authorized access to report online and you fall into one of these categories, please complete and submit a Request Online Reporting Access Form.

To complete a secure and protected* online event report, please click on the Submit Online Event Report link below.

**button for Submit Online Incident Report will go here**

*Confidential and may be subject to the attorney-client privilege or may constitute privileged work product. The information may also be privileged and confidential pursuant to Section 1004.24, Florida Statutes and Florida Board of Governors Regulation 10.001.

REMINDER

As a covered Healthcare Liability Self-Insurance Program (SIP) provider, it is essential and expected that you notify us immediately if:

• You were involved, or alleged to have been involved, in an event while delivering healthcare services that may have caused or resulted in an injury (real or perceived) to a patient
• You received a complaint, legal notice, or licensure investigation notice related to your delivery of healthcare services
• You received a subpoena for deposition or medical records

See our Event Reporting Guide for additional examples of when to contact SIP.

Once we are placed on noticed of the reporting, a SIP examiner will immediately go into action to meet the needs of patients with meritorious claims, aggressively and effectively defend those claims that lack merit, and assist in patient safety initiatives to improve the provision of healthcare.

NOTE: You may have additional reporting responsibilities (e.g., facility risk management, program directors, attendings) and should be familiar with the policy for reporting events and near misses at the facilities where you practice.