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Designation Notice under the Family and Medical Leave Act. S. Department of Labor Wage and Hour Division DO NOT SEND TO THE DEPARTMENT OF LABOR. PROVIDE TO EMPLOYEE.OMB Control Number: 12350003 Expires:

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How to fill out wh-382

01

Start by entering the date of the injury in the 'Date of Injury' field.

02

Fill in the employee's name and address in the designated spaces.

03

Enter the name and contact information of the supervisor or foreman who is reporting the injury.

04

Provide details about the injury, including the body part affected and a description of how it occurred.

05

The employee should sign and date the form after reviewing the information provided.

Who needs wh-382?

01

Employees who have suffered a work-related injury or illness.

02

Supervisors or foremen who are responsible for reporting such injuries.

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What is wh-382?

Wh-382 is a form used to report work-related injuries and illnesses.

Who is required to file wh-382?

Employers are required to file wh-382 when a work-related injury or illness occurs.

How to fill out wh-382?

Wh-382 should be completed with detailed information about the work-related injury or illness, including date of occurrence, nature of the injury, and any medical treatment provided.

What is the purpose of wh-382?

The purpose of wh-382 is to track and report work-related injuries and illnesses to ensure proper recordkeeping and compliance with regulations.

What information must be reported on wh-382?

Wh-382 requires information such as employee name, job title, date of injury or illness, description of the incident, and any medical treatment provided.

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