Get First Report Of Injury Form - Dhmh - Maryland.gov - Dhmh Md

The First Report Of Injury Form is an essential document used to report work-related injuries. This guide will provide clear instructions on how to effectively complete this form online, ensuring that you meet all necessary requirements.

Follow the steps to successfully fill out the First Report Of Injury Form

1. Press the ‘Get Form’ button to access the First Report Of Injury Form and open it for completion.
2. Begin by entering the employee's name, ensuring to specify their gender in the designated area. Fill in the employee's date of birth.
3. Input the employee's current job classification and the duration of their employment. Also, provide the Social Security number if required, along with their weekly salary.
4. Describe the bodily injury sustained by the employee, being specific about the body part(s) affected.
5. Record the name and contact information of the supervising individual, along with the names and contact details of any witnesses to the accident.
6. Finally, ensure that the employee signs the form and dates it to confirm the accuracy of the information provided. Review all entries before submission.
7. After completing the form, save changes as necessary. You can download a copy, print it for records, or share it with the relevant parties as required.

Take the next step and fill out the First Report Of Injury Form online to ensure timely processing of your report.