Get Instructions Supervisor's First Report Of Injury Or Illness

Filling out the Instructions Supervisor's First Report of Injury or Illness accurately and promptly is essential for streamlining the process of reporting workplace injuries. This guide offers step-by-step instructions to help supervisors complete the form efficiently and effectively.

Follow the steps to accurately complete the report online.

1. Click the ‘Get Form’ button to access the report form and open it in your preferred editing tool.
2. In the form, begin by entering your name, employee ID, and social security number in the designated fields. Ensure all personal data is accurate.
3. Provide the employee's work telephone number and department name. Fill in the marital status, race, and date of birth as required.
4. Specify whether the employee speaks English and provide their home or mailing address, including any relevant contact details.
5. Indicate the treating doctor's name if medical treatment is involved, and record the date and time of the injury.
6. Detail the type of injury sustained, including the exact body part affected, and describe the accident occurrence thoroughly.
7. Answer whether the employee was performing their regular duties at the time, along with specifying the location and cause of the incident.
8. List all witnesses present during the event along with their contact information.
9. Indicate the return to work date if applicable and state if the employee died due to the incident.
10. Complete the supervisor’s section by providing your name, signature, title, work phone number, and date.
11. After reviewing all filled sections for accuracy, save your changes. You may also download, print, or share the completed report.

Ensure timely and accurate reporting by completing the Instructions Supervisor's First Report of Injury or Illness online.