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UC Davis Health SystemDESIGNATION OF PHYSICIAN Formic you become injured at work, NOTIFY YOUR SUPERVISOR IMMEDIATELY. Your supervisor will direct you to Employee Health Services if care is needed,
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How to fill out if you become injured

01
To fill out if you become injured, follow these steps:
02
Assess your injury and determine the severity. If it is a minor injury that can be treated at home, proceed to the next step. If it is a serious injury requiring immediate medical attention, call emergency services.
03
Gather necessary information such as personal details, the date and time of the incident, the location, and any witnesses present.
04
Contact your employer or supervisor to report the injury and provide them with the necessary information. They will guide you through the specific procedure of filling out the injury report.
05
Obtain any required forms or documents from your employer or HR department. These may include incident report forms or accident claim forms.
06
Fill out the forms accurately and provide detailed information about the injury, how it occurred, and any contributing factors.
07
Attach any supporting documents or evidence, such as medical reports, photographs, or witness statements.
08
Submit the completed forms to the appropriate person or department as instructed by your employer. Make sure to keep a copy for your records.
09
Follow any further instructions or procedures provided by your employer, such as seeking medical treatment or arranging a follow-up meeting.
10
Remember to always consult with your employer or HR department for specific guidelines and requirements.

Who needs if you become injured?

01
Anyone who becomes injured, regardless of the severity of the injury, needs to fill out an injury report. This includes:
02
- Employees who sustain work-related injuries or illnesses
03
- Individuals who suffer injuries in public places or as a result of someone else's negligence
04
- Athletes or sports participants who get injured during games or training sessions
05
- Individuals involved in accidents or incidents where there may be liability or insurance matters
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Filling out an injury report is crucial to ensure proper documentation, investigation, and potential compensation for the injured party.

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If you become injured at work, NOTIFY YOUR SUPERVISOR IMMEDIATELY template instructions

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