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U.S. Department of LaborEmployer's First Report of Injury or Occupational IllnessOffice of Workers Compensation Programs(See instructions on reverse)Print OMB No. 12400003Reset1. OCP No.2. Carrier's
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How to fill out indicate where injury occurred

01
To fill out indicate where injury occurred, follow these steps:
02
Start by examining the injured person's body to locate the exact site of the injury.
03
Use a pen or marker to draw a small circle or mark around the area where the injury occurred.
04
Be as specific as possible when indicating the location. If it's a larger area, you can draw arrows or lines to outline the boundaries of the injured area.
05
If there are multiple injuries, make sure to label each mark or circle with a corresponding description or number.
06
Double-check your markings to ensure they are clear and easy to understand for others reading the form.
07
If you are filling out a digital form, there may be a designated field or option to indicate the location of the injury. Click on or select the appropriate area on the digital form.
08
Finally, review the completed form to make sure all information, including the indicated injury location, is accurate and legible.

Who needs indicate where injury occurred?

01
Anyone who is filling out an injury report or form needs to indicate where the injury occurred.
02
This includes:
03
- Individuals who have sustained injuries and are reporting them for medical or legal purposes.
04
- Medical professionals who need to document patient injuries in medical records.
05
- Employers or supervisors who are responsible for filing workplace injury reports.
06
- Insurance agents or adjusters who are processing injury claims.
07
- Any other individuals or entities involved in the documentation or investigation of an injury.
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Indicate where injury occurred is a section on a form where the location of the injury is noted.
The person or entity responsible for documenting the injury is required to file indicate where injury occurred.
To fill out indicate where injury occurred, simply write down the specific location where the injury took place.
The purpose of indicate where injury occurred is to accurately document the location of the injury for record-keeping and analysis purposes.
The information reported on indicate where injury occurred should include the specific address or description of the location where the injury occurred.
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