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Report of Student Accident

The Report of Student Accident (formerly PS 106) is now an electronic Cognito form. Effective immediately, please use this link to complete and submit the report. Paper forms will no longer be accepted. Please do not print completed forms. Once a form is submitted, the appropriate people will have access to view the submission.

Report of Student Accident Form

Please complete the form ASAP, but no longer than 48 hours, post-accident/injury.

If you have questions about the form, please contact:

Tammy Metcalf
301-475-5511 X32205

Contact Information

Mike Watson
Director of Facility Coordination, Physical Education, and Athletics

27190 Point Lookout Rd.
Loveville, MD 20656

301-475-4256 ext. 34143