- a) the name of the affected individual;
- b) the date of the injury;
- c) identification of the tanning equipment involved in the injury;
- d) the name, location and permit number of the tanning facility involved;
- e) the nature of the injury;
- f) the name and address of the affected individual's health care provider, if any; and
- g) any other information considered relevant to the situation.
A written report of any tanning injury or alleged injury shall be sent to the Department by the facility within ten (10) working days after its occurrence or knowledge thereof. The report shall include: