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If an injury or illness requires medical treatment beyond first
aid, you should provide the employee the following forms:
- Medical Service Order
- Employee/Volunteer Injury/Illness Report and
- “Employee’s Claim for Workers’ Compensation
Benefits” form.
State law requires that an Employee’s Claim Form be provided to
an employee within 1working day of your notice or knowledge of the
work-related injury or illness. This form is available from the
Risk Management office, CP-700 extension 7346.
Immediately submit the completed and signed (1) Employee/Volunteer
Injury/Illness Report, (2) Employee’s Claim Form
and (3) Medical Service Order (if available) to University
Risk Management (CP-700). These forms are available in your department
office, on this website under the heading "Forms" or by
calling Risk Management at extension 7346 or 2824.
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