Forms and other worker's compensation information

Reporting the injury, illness, or exposure

Employees

Injury report Employee's work injury and illness report

English | Spanish/Español
Hmong/Hmoob | Tibetan

Supervisors

Injury report Employer's first report of injury or disease

English only

Supervisors

Accident analysis
Supervisor's Accident Analysis and
Evaluation of Repetitive Motion and/or
Material Handling Activities

English only

 

Other forms

Voluntary and Informed Consent for Disclosure of Health Care Information – Employee

Safety Coordinator's Review – Safety coordinator, safety committee, or other designated individual or group

Forms for Worker's Compensation Coordinators

  1. STARS Web Access Request and User Agreement
  2. STARS Workstation Requirements

 

Page last saved: 04/21/2014