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Burn Injury Reporting

Nurse dressing wound for patients hand with burn injury

Iowa Code Chapter 147.113A requires any person licensed under Chapter 147 who administers any treatment to a person suffering a burn report that injury.  Below is a general burn injury report form that may be used for reporting burn injuries.  Please submit this form to the local law enforcement agency within whose jurisdiction the burn or burn injury occurred.  Also email a copy of the form to the State Fire Marshal Division of the Iowa Department of Public Safety at for tracking purposes.

Iowa Burn Injury Report form