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Injury Reporting Information and Forms

Supervisors Report of Injury Form (HR Form)

Student and Visitor Injury or Accident Report (Copy S&RM. UPD and Department)

Incident and Accident Reporting (NOT involving vehicles)

The single most important response action in the case of student, visitor or employee injury is to contact University Police to ensure that emergency medical services are made available to the injured person(s) as quickly as possible.

Students, visitors, and others should report incidents and/or accidents by contacting University Police or Risk Management in non-Emergency situations.  Students should report to the Faculty supervising during the time of the incident if the incident occurs during class or laboratory session.  Risk Management will follow up with the responsible University staff regarding the reported Accident/Incident.

Serious Incidents / Incidents Must Be Reported to University Police Department as soon as possible and will be assigned a UPD case number. 

  • Faculty and Staff should complete the California State STD 268 within  48 hours of the accident.
  • Student and visitors should file a campus Incident Report. 
Based upon the nature of the incident/accident, Risk Management will investigate and may provide recommendations or request repairs, notify insurers, and ensure full documentation of the incident for purposes of prevention of future injuries and for managing any claims that may result.

If injured on the job, employees are to report (where, when, and how the accident happened) and get immediate treatment. Employees will contact their supervisor and the Human Resources Department to get authorized medical treatment. Employees will be required to fill out all necessary paperwork for work related injuries. If there is an immediate emergency, employees are to get the best treatment available and then report the injury to the appropriate supervisor and the Human Resources Department as quickly as possible.

Please contact the Office of Safety & Risk Management for more information

(661) 654-6320