Reports of injury

If a customer of a tanning facility reports a sunburn injury to that facility resulting from the use of its tanning device, the owner shall provide the customer with written information on how to report the alleged injury to the department on a form prescribed by the department. The report shall be sent to the department as soon as possible and shall include: 1. The name of the affected individual and date of the actual or alleged injury. 2. The name and location of the tanning facility. 3. The nature of the alleged injury and duration of the tanning exposure. 4. Information on the device involved, such as manufacturer and model number and any other information considered relevant to the situation. 5. The name and address of the health care provider and treatment, if any.