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Swimming Pool Accident Report
This information is provided by the Nebraska Department of Environment and Energy to assist the public and regulated community.
Form #:
WAT297
Applications and Forms
Revised:
7/1/21
Size
File Name
124 KB
WAT297 Pool Accident Report 7-2021.pdf
The pool owner or the Nebraska swimming operator must
immediately
notify the Department at 402-525-6601 of any drowning or near drowning. This report must then be completed and returned to the Department.
Any accident occurring on the pool premises requiring hospitalization or medical treatment must be reported within 24 hours by completing and submitting this form to the Department.
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NDEE Private
245 Fallbrook Blvd Suite 100, Lincoln, NE 68521 -- PO Box 98922, Lincoln, NE 68509 -- phone (402) 471-2186, toll-free (877) 253-2603