Staff Injury Reporting Process

STEP #1 - Let your administrator know and fill out the Workers Report of Occupational Injury form. Please let the building secretary know if a work order needs to be done to prevent further injuries.

Workers Report of Occupational Injury(fill out first)

Instructions

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STEP #2 - If you seek medical attention or if you incur time loss, please fill out the 801 form linked here and contact Human Resources. Your building Safety Committee Representative will contact you about Step #3.

SAIF 801 Form

Fill out the top portion 1-29, sign it and send it to [email protected]

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STEP #3 - Building Safety Committee Representative will conduct an Employee Accident/Incident Analysis

Safety Committee Rep (Incident Analysis)

Instructions

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Employee Accident Flow Chart

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Contacts:

Jennifer Evers - Business Office Secretary 503-359-2408, ext 4555

Jennifer Brewer - Workers Comp (SAIF) 503-357-6171, ext 4525

Leticia Gutierrez - Human Resources 503-357-6171, ext 4522