Employee Injury or Illness Report - Supervisor Statement

Service Overview

If you are the supervisor of an employee who has been injured or become ill from a work-related cause, use this form to officially document and detail the circumstances surrounding an employee's work-related injury or illness. Must be completed as soon as possible.

Available To

  • Faculty
  • Staff

Related Services

Employee Injury or Illness Report

Witness Statement of Employee Injury or Illness

Questions?

For questions regarding this service or assistance with the request form, contact Human Resources at hr@udayton.edu or (937) 229-2541.