Get First Report Of Injury Form - The Trust

Filling out the First Report Of Injury Form - The Trust online is an essential task that must be handled promptly after an incident occurs. This guide aims to provide a clear and comprehensive approach to completing the form to ensure accurate reporting.

Follow the steps to complete the form effectively.

1. Click ‘Get Form’ button to access the form and open it in your preferred editor.
2. Begin by providing your employer information. Enter the employer name and mailing address. If the street address differs from the mailing address, include that as well. Specify the nature of the employer’s business and add the appropriate phone number.
3. Next, fill in the employee information section. This includes the injured employee’s full name, social security number, gender, address, and home phone number. Additionally, record the employee's date of hire, marital status, occupation, and other relevant details such as their time to begin work, date of birth, department, hours worked per day, age, dependents, work phone, days worked per week, and weekly wages at the time of injury.
4. Proceed to the injury or exposure information section. Document the date and time of the injury, the location where it occurred, and whether it was on the employer's premises. Specify the object causing the injury, the type of injury sustained, and the specific part of the body affected. Include a detailed description of the events leading to the injury or disease.
5. List any witnesses to the incident, including their names, addresses, and phone numbers. Indicate whether treatment was sought in an emergency room and provide the name and address of the treatment location if known.
6. Document the date the employer was notified about the injury and whether the employee was hospitalized overnight. If applicable, provide the name and address of the hospital, the date lost time began, and whether the employee has returned to work.
7. Conclude by filling in information related to the preparer, including the name, title, and phone number of the person completing the form. Also, indicate the date the form was prepared.
8. After completing all fields accurately, review the information for any errors. Once confirmed, you can save the changes, download a copy, print it, or share the form as needed.

Get started today by completing the First Report Of Injury Form online.