Public Safety

EMPLOYEE INJURY REPORT FORM

Instructions for Employees

All employees are required to report all injuries/accidents

  • Contact the Department of Public Safety immediately

  • Notify your supervisor as soon as possible

  • Complete the “ACCIDENT/INCIDENT Employee Statement” form (SGWCP-2) below and submit within 48 hours of incident.

  • Employees are to go to a Fast Med Urgent Care location and present this form