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.
|Notification to Participate
||Notification of Requirement to Participate in the Survey of Occupational Injuries and Illnesses - Calendar Year 2016
||This form is sent to establishments selected to participate in the 2016 SOII. This notification instructs survey
participants to maintain the required information for all recordable work-related injuries and illnesses that occur during calendar year 2016 for
the location identified on the front under the heading "Maintain Records for:" Establishments will receive the survey form to report their 2016
information in early 2017.
|OSHA Forms (subset)
||OSHA's Form 300, "Log of Work-Related Injuries and Illnesses"
OSHA's Form 300A, "Summary of Work-Related Injuries
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
|Instructions for Electronic Survey
||Instructions for the Survey of Occupational Injuries and Illnesses, 2015 (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 2015 SOII sample.
Printable Survey Form
||Survey of Occupational Injuries and Illnesses, 2015 (Form BLS-9300 N06)
||This is the standard 8-page survey form for reporting your work-related injuries and illnesses to the Bureau of
|Survey Form (fillable)
||Survey of Occupational Injuries and Illnesses, 2015 (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 312, 452, 492, 562, 622, and 721.
|Spanish Survey Form
||Encuesta Sobre Lesiones y Enfermedades Occupacionales, 2015 (Form BLS-9300 N06)
||This is the standard 12-page survey form in Spanish that our sampled establishments in Puerto Rico use.
||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 2015, you
may respond to us via FAX using a FAX form.
Last Modified Date: December 18, 2015