The Accident-Incident Reporting Form is to be used by persons authorized by the facility or service Administrator to report a serious accident or incident to the Bureau of Health Facilities Licensing. A serious accident or incident is defined in the applicable regulation under which the facility or service is licensed by the Department. Health regulations can be viewed here. Please do not send additional documents unless requested by the Department.
Download "Accident-Incident Reporting Form (DHEC Form 0953)" and follow the instructions located on the second page of the form.