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

________________________________________________________________

STEP #2 - If you seek medical attention, 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]

________________________________________________________________

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

Safety Committee Rep (Incident Analysis)

Instructions

________________________________________________________________

Employee Accident Flow Chart

________________________________________________________________

Contacts:

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

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

Jo Shields - Human Resources - 503-357-6171, ext 4549