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Updated 05/2016 Employee s Report of Injury (To Be Completed by the employee only.) Employee s name: Male ...

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What is report of injury form?

The report of injury form is a document used to report workplace injuries and accidents to the appropriate authorities.

Who is required to file report of injury form?

Employers are required to file a report of injury form when an employee is injured on the job.

How to fill out report of injury form?

The report of injury form should be filled out by providing details of the injured employee, the circumstances of the injury, and any medical treatment received.

What is the purpose of report of injury form?

The purpose of the report of injury form is to document workplace injuries, track trends in injuries, and ensure that proper care is provided to injured employees.

What information must be reported on report of injury form?

The report of injury form should include details such as the date and time of the injury, the location where it occurred, the nature of the injury, and the name of the injured employee.

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