Get Indiana State University Form 5-wc 2017-2025
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How to fill out the Indiana State University Form 5-WC online
Filling out the Indiana State University Form 5-WC is an essential step for reporting workplace incidents and injuries promptly. This guide provides a clear, step-by-step approach to assist users in accurately completing this important form online.
Follow the steps to accurately complete the Indiana State University Form 5-WC online.
- Press the ‘Get Form’ button to obtain the form and open it in the editor.
- Enter today's date in the appropriate section of the form.
- Provide your Employee ID number and full name in the designated fields.
- Fill in your job title, home address, home or cell phone number, date of birth, and date of hire.
- Indicate your department name and department organization number, along with the department's phone number.
- Record your supervisor's name in the corresponding field.
- Input the date and time of the incident, specifying whether it occurred in the AM or PM.
- Detail the location of the incident, including the building and area where the injury happened.
- Provide a concise description of your injury and how the incident occurred.
- Check the specific type of injury or illness you experienced from the provided options.
- Check all applicable parts of the body that were affected by the incident.
- List all equipment, materials, and chemicals involved in the incident.
- Answer whether you sought treatment at the Center for Occupational Health or the hospital for emergency care.
- Indicate if you have missed any work due to the injury and list the dates and times missed, if applicable.
- Mark whether there were any witnesses to the incident, and provide their names and phone numbers if available.
- Complete the certification statement by confirming the information provided is true and correct. Sign and date the form.
- Have your supervisor sign and date the form, along with the department head if required.
- Finally, save your changes, and choose to download, print, or share the form as necessary.
Complete and submit the Indiana State University Form 5-WC online today to ensure prompt processing of your incident report.
To be considered for admission to Indiana State University, you generally need a minimum GPA of 2.5. However, since admissions can be competitive, maintaining a GPA above this can be beneficial. Remember, the admissions process evaluates more than just GPA, including your involvement and achievements. Completing your Indiana State University Form 5-WC with careful attention will help present your overall profile effectively.
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