UT Employee Injury Report Form 2011-2025 free printable template

Department of Human Resource Management Use this form when no WCF claim is filed to document injury. Form 122 found on www.wcf.com should only be used when claim is filed with WCF EMPLOYEE INJURY

How to fill out UT Employee Injury Report Form

How to fill out UT Employee Injury Report Form

1. Obtain the UT Employee Injury Report Form from your supervisor or the HR department.
2. Fill in your personal details including your name, employee ID, and department.
3. Provide details of the injury, including date, time, and location of the incident.
4. Describe the nature of the injury and how it occurred in the explanation section.
5. Include any witnesses' names and contact information, if applicable.
6. Sign and date the form to affirm that the information provided is accurate.
7. Submit the completed form to your supervisor or the designated department responsible for employee injuries.

Who needs UT Employee Injury Report Form?

1. All UT employees who have suffered an injury or accident while performing work-related duties need to fill out the UT Employee Injury Report Form.

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What is UT Employee Injury Report Form?

The UT Employee Injury Report Form is a document used to report injuries sustained by employees while performing their job duties at the University of Texas.

Who is required to file UT Employee Injury Report Form?

Any employee who sustains an injury related to their work responsibilities at the University of Texas is required to file the UT Employee Injury Report Form.

How to fill out UT Employee Injury Report Form?

To fill out the UT Employee Injury Report Form, an employee should provide details about the injury, including the date, time, location of the incident, a description of how the injury occurred, and any witnesses present.

What is the purpose of UT Employee Injury Report Form?

The purpose of the UT Employee Injury Report Form is to document workplace injuries, ensure proper medical treatment, track trends in workplace safety, and comply with legal and regulatory requirements.

What information must be reported on UT Employee Injury Report Form?

The information that must be reported on the UT Employee Injury Report Form includes the employee's name, job title, date and time of the incident, details about the injury, circumstances leading to the incident, and any medical treatment received.