Safety Incident Forms
Complete Form 122 (Employers First Report of Injury or Illness)
Complete the college's Accident-Injury Incident Report Form
Frequently Asked Questions
- How soon does my employee need to complete Form 122?
- Within 24 hours of the incident when possible. Otherwise, as soon as possible.
- Where do I send Form 122 when it's complete?
- If my employee needs to go to the doctor/hospital and the form has not been filled
out, what do I do?
- Go to the doctor, submit the form as soon as you are able.
- Does HR need a copy of my Doctor's note?
- Will somebody contact my employee?
- The employee will be contacted by a Worker's Comp adjuster. If HR has questions they
will contact the supervisor or employee.
- If my employee is given restrictions what do I do?
- Contact Linda in HR to see if we can accommodate.