SOII forms are available for download as PDF files. You will need Adobe Acrobat Reader to view the form. Adobe Acrobat Reader is a free software program that allows you to view Portable Document Files (PDF). You may download it at no cost from Adobe's Web site.
| Form | Form Name | Description |
|---|---|---|
| Notification to Participate | Notification of Requirement to Participate in the Survey of Occupational Injuries and Illnesses - Calendar Year 2013 | This form is sent to establishments selected to participate in the 2013 SOII. This notification instructs survey participants to maintain the required information for all recordable work-related injuries and illnesses that occur during calendar year 2013 for the location identified on the front under the heading "Maintain Records for:" Establishments will receive the survey form to report their 2013 information in early 2014. |
| OSHA Forms (subset) | OSHA's Form 300, "Log of Work-Related Injuries and Illnesses" OSHA's Form 300A, "Summary of Work-Related Injuries and Illnesses" OSHA's Form 301, "Injury and Illness Incident Report" |
This is a subset of the full OSHA Recordkeeping forms package. It includes the OSHA Form 300, OSHA Form 300A, and the OSHA Form 301. To obtain a complete set of OSHA Recordkeeping forms, you can download them from OSHA's website: http://www.osha.gov/recordkeeping/RKforms.html |
| Instructions for Electronic Survey | Instructions for the Survey of Occupational Injuries and Illnesses, 2012 (Form BLS-9300-IDCF) | These instruction explain how to submit your data electronically. This set of instructions is sent to all sampled establishments who are in the 2012 SOII sample. |
| Printable Survey Form | Survey of Occupational Injuries and Illnesses, 2012 (Form BLS-9300 N06) | This is the standard 8-page survey form for reporting your work-related injuries and illnesses to the Bureau of Labor Statistics. |
| Survey Form (fillable) | Survey of Occupational Injuries and Illnesses, 2012 (Form BLS-9300-N06) | This is an electronic survey form for reporting your work-related injuries and illnesses to the Bureau of Labor Statistics. To receive this fillable PDF version of the survey, please send an e-mail to your State. This form is not currently available for respondents in NAICS industries beginning with 238, 311, 444, 481, 493, and 623. |
| Spanish Survey Form | Encuesta Sobre Lesiones y Enfermedades Occupacionales, 2012 (Form BLS-9300 N06) | This is the standard 12-page survey form in Spanish that our sampled establishments in Puerto Rico use. |
| FAX Form | FAX Response Form (Form BLS-9300 FAX) | If there were few or no work-related injuries and illnesses at your sampled establishment in calendar year 2012, you may respond to us via FAX using a FAX form. |
Last Modified Date: December 20, 2012