Environmental Health & Safety
Supporting the campus community by proactively protecting people, property and the environment in a responsible and cost effective manner.

Report an Injury, Safety Concern or Near-Missed

Section 1

Report an Injury, Safety Concern or Near-Miss

Injuries, safety concerns or near-misses occurring on campus or while participating in University business should be reported within 24 hours. For non-vehicle property damage ONLY, please see HOW TO: Report Damaged or Destroyed Property.


Instructions: Please complete the following and click CONTINUE to report an incident.
If more than one person was injured, please submit a report for each person.

 

1. Select the information that best describes the incident:


2. What is the affiliation of the person for whom this form is being completed?

  
  
  
  
  

3. Was a vehicle involved?   


Resources

CAMPUS: Human ResourcesInsurance & Risk Management

MEDICAL CENTER: Workers' Compensation : Environmental Health & Safety