Get Employee Illness Reporting Form

Completing the Employee Illness Reporting Form online is a crucial step for users who have experienced an injury or occupational illness. This guide will provide you with clear and detailed instructions on how to effectively fill out the form to ensure accurate and timely reporting.

Follow the steps to complete the form online:

1. Press the ‘Get Form’ button to access the form and open it in your preferred editor.
2. Begin by entering your personal information in the Employee Identification section. This includes your name, home mailing address, department, work phone, Banner ID number, gender, birth date, hire date, and job title.
3. Indicate whether the incident occurred on university property or during university business by selecting 'Yes' or 'No' in the provided fields.
4. In Part 1, document the injury or illness specifics. Enter the date and time of the incident, along with a detailed description of the events leading to the injury.
5. Record any witnesses to the incident and their contact information, noting if you have informed your supervisor of the incident.
6. Specify the body part injured and the nature of the injury from the provided options.
7. If applicable, answer the questions relating to back strains or similar injuries, providing comprehensive responses to each inquiry.
8. Sign the form at the bottom, affirming that the information provided is true to the best of your knowledge, and include the date of signing.
9. After completing the form, you have the option to save changes, download, print, or share the completed document as needed.

Begin filling out your Employee Illness Reporting Form online today!