Injury Report Form Templates

This document is an incident/injury report specific to the Texas A&M University System in Texas. It is used to report any incidents or injuries that occur within the university system.

This Form is used for reporting any injuries or property damage incidents that occur on Truman State University campus.

This document is used to report accidents or injuries that have occurred. It is in black and white format.

This form is used for reporting unusual incidents, injuries, or deaths in California.

This Form is used for initiating treatment for a head injury.

This Form is used for reporting any unusual incidents or injuries that occur in a family child care home in California.

This form is used for reporting personal injuries within the US Army Recruiting Command.

This form is used for reporting any property damage or personal injury that occurred within GSA (General Services Administration) or non-GSA employees. It helps to document and handle any necessary claims or compensation.

This form is used for reporting the first injury that occurred at the workplace in the state of Colorado.

This document is for employers in Alaska to report 45 consecutive days of time loss for injuries suffered by their employees.

This document is used for reporting any injury or illness that occurs in the state of Delaware. It helps to provide necessary information for insurance or legal purposes.

This Form is used for workers in Arizona to report an injury that occurred while on the job.

This Form is used for employers in Arizona to report industrial injuries suffered by their employees.

This Form is used for reporting a worker's injury in Arizona. It requires information from both the worker and the physician involved.

This Form is used for reporting the first injury in the state of Colorado.

This form is used for reporting accidents, injuries, and emergency medical care in Missouri. It is known as Form MO580-2123 (BCC-106).

This Form is used for reporting accidents, injuries, or emergency medical care in the state of Missouri.

This Form is used to report accidents or injuries that occur in various settings, such as the workplace or on the road. It provides a detailed account of the incident, including information about the individuals involved, the cause of the accident, and any resulting injuries. This document is typically used by employers, insurance companies, or legal authorities to assess liability and determine the appropriate course of action.

This Form is used for reporting workplace injuries in Missouri through the Electronic Data Interchange (EDI) system.

This form is used for reporting the termination of temporary total disability (TTD) or temporary partial disability (TPD) in the state of Indiana.

This Form is used for reporting employee injuries or illnesses that occur in the state of Michigan. It helps employers comply with state regulations and keep a record of workplace incidents.

This form is used for reporting serious injuries that occurred in the state of Minnesota.

This form is used for reporting accidents or injuries that occur in Montana. It helps gather information about the incident and is necessary for insurance purposes or legal claims.

This form is used for employers in New Hampshire to report additional information regarding a work-related injury.

This Form is used for health care providers in New Jersey to report occupational and environmental diseases, injuries, or poisonings.

This form is used for reporting complaints or injuries related to the Medical Cannabis Program in New Mexico.

This Form is used for reporting work-related injuries or illnesses by employers in New York. It is specifically tailored for Chinese-speaking individuals.

This form is used for employers in New York to report work-related injuries or illnesses. The form is available in Korean language.

This document is used for submitting an Ancillary Medical Report in New York State. It is used to provide additional medical information related to a worker's compensation claim.

This form is used for reporting occupational illnesses or injuries. It helps document information regarding the incident, including the nature of the illness or injury, treatment provided, and any contributing factors.

This form is used for documenting and recording injuries related to youth flight activities.

This Form is used for employers in Vermont to report the first injury or illness that occurs on the job.