Injury or Illness Report


    INSTRUCTIONS: This report should be submitted by individuals who have injuries on the UA campus. Also, employees who have an injury or illness that may be covered under the UA On-the-Job Injury and Illness Policy should complete this form.

    Report Injury or Incident

    Expected format: mm/dd/yyyy HH:MIPM
    Copyright © 2023 Office of Environmental Health and Safety | Tuscaloosa, AL 35487 | (205) 348-0000