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“NOTICE OF INJURY OR OCCUPATIONAL DISEASE (Incident Report) Pursuant to NRS 616C.015 Name of Employer Name of EmployeeSocial Security Numerate of AccidentTime of Accident(if applicable)(if applicable)Telephone
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01
Open the website where the online notice of injury form is available.
02
Fill in your personal information such as your name, address, and contact details.
03
Provide details about the injury, including the date, time, and location of the incident.
04
Describe the nature of the injury and any other relevant information.
05
Attach any supporting documents or evidence, such as medical reports or witness statements.
06
Review the information you have provided to ensure accuracy.
07
Submit the completed online notice of injury form.
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Keep a copy of the submission for your records.

Who needs online notice of injury?

01
Anyone who has suffered an injury and wishes to report it officially.
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The online notice of injury is a digital form used to report an injury that occurred in the workplace.
Employees who have been injured while on the job are required to file an online notice of injury.
The online notice of injury can be filled out by providing information about the injury, the circumstances surrounding it, and any medical treatment received.
The purpose of the online notice of injury is to document workplace injuries and ensure that employees receive proper medical care and compensation.
Information such as the date and time of the injury, the location where it occurred, a description of the injury, and any medical treatment received must be reported on the online notice of injury.
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