When you have had an on the job injury, please print all three forms listed below. Follow the directions on Form 1, then fill out and return Forms 2 & 3 to the Finance Officer. It is VERY important that Forms 2 & 3 be printed, filled out, and returned within 5 days of your injury. Failure to meet these requirements can seriously impede the status of your claim.

Form 1: Instructions

Form 2: Employee's Statement of Injury

Form 3: Supervisor Report of Accident Investigation