Injury Report Form Templates

This form is used for providing a 24-hour notice of any incident or injury that occurred in Rhode Island.

This Form is used for reporting injuries or accidents that occur in Virginia.

This document is used for reporting incidents or injuries in Rhode Island.

This form is used for reporting and documenting abbreviated ground accidents for the U.S. Army. It helps gather information about accidents that occur on the ground, such as vehicle collisions or equipment malfunctions.

This form is used for summarizing work-related injuries and illnesses in the state of New York.

This Form is used for recording accidents that occur on a contractor's job site in California. It helps document the details of the accident and any injuries or damages that occurred.

This document is used for reporting the progress of a patient's treatment by their primary treating physician in the state of California.

This form is used for reporting burn injuries that occur in the state of Connecticut. It is a document that individuals or healthcare professionals can use to report information about burn injuries, including the cause, severity, and treatment of the injury. The form helps in gathering data on burn injuries in Connecticut and assists in developing prevention strategies and providing appropriate medical care.

This form is used for reporting the first injury that occurred in Virginia. It must be completed and submitted to the Virginia Workers' Compensation Commission.

This form is used for reporting the first injury occurring at the workplace in Connecticut.

This form is used for reporting self-insured injuries in the state of Arizona. It provides a way for individuals to document and report any injuries they have sustained while under a self-insured insurance plan.

This form is used to report injuries for Portuguese employees at USAFE BASE. It is available in both English and Portuguese.

This document is used for reporting injuries or incidents that occur in the state of New Hampshire. It helps gather information about the incident and any resulting injuries for documentation and potential legal purposes.

This Form is used for employers in Oklahoma to report the first notice of an employee's injury.

This document is for reporting injuries that occur in licensed child care facilities in Rhode Island. It is used to ensure the safety and well-being of children in childcare settings.

This form is used for reporting bloodborne pathogen exposure incidents in Oklahoma. It is an attachment to form MSRM140125.02.

This form is used for reporting the first injury in South Dakota.

This form is used for reporting an injury and providing information about the total losses incurred as a result. It is specific to the state of Utah.

This Form is used for reporting the first injury or illness that occurred in the state of Utah.

This form is used for reporting amusement ride accidents or injuries that occur in Oklahoma.

This form is used for reporting employee injuries in the state of Missouri for the purpose of filing a workers' compensation claim.

This form is used for reporting serious injuries involving license exempt providers in Michigan.

This form is used for reporting workplace injuries and illnesses in California. It is required by Cal/OSHA and is used to provide information about the incident, such as the date, time, and cause of the injury or illness.

This document is used to report accidents that occur in the state of Iowa. It is important in documenting the details and circumstances of the accident for insurance and legal purposes.

This document is used to report any injuries sustained by a supervisor in the state of Montana. It helps to document the details of the injury and ensure that proper procedures are followed for reporting and addressing the incident.

This Form is used for doctors in New York to submit their initial report. It is a required document for reporting medical conditions and treatments.

This Form is used for reporting injuries and poison exposure incidents in Oklahoma.

This document is a Water Recreation Facility Injury Report Form specific to the state of Washington. It is used to report injuries that occur at water recreation facilities.