Company Incident Report

Report an Incident

Submit this form as soon as possible after any incident, injury, near-miss, or accident at any GreenPoint work site. For life-threatening emergencies, call 911 first, then call Miguel Garcia at 347-332-9348.

This form sends your report directly to Miguel Garcia at info@greenpointms.com. If you provide your email, you will receive a timestamped acknowledgment copy for your records.

Reporter Information

Your Full Name *

Your Email

Your Phone

Incident Details

Workplace Address *

Where did the incident occur?

Date of Incident *

Approximate Time

Type of Incident

What Happened

Describe the incident in detail *

Include what you were doing, how it happened, what equipment or materials were involved, and any conditions that contributed.

Witnesses (if any)

Name(s) of anyone who saw what happened.

Injury & Medical

Did an injury occur?

Was medical attention received?

By submitting, you confirm the information is accurate to the best of your knowledge.

Emergency? For life-threatening injuries, call 911 first, then Miguel Garcia at 347-332-9348.
Prefer to report another way? Email info@greenpointms.com or call/text 347-332-9348.