SAIF Forms

SAIF Forms

These forms make up a packet for the supervisor and employee should an accident or injury occur on campus.

The forms are either in Adobe Acrobat (pdf) or MS Word.

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Name of Form
PDF Format
Word Format
Supervisor’s Instructions for Reporting On-the-Job Injuries
Employee Instructions for Reporting On-the-Job Injuries
Accident Report Form – No Medical Attention
Supervisor’s On-the-Job Accident, Illness Investigation
Notice to the Physician
Worker’s Compensation Associated Leave Choices
Worker’s Compensation Claim Form 801

Contact information for Human Resources

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