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

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.