Emergency / Risk Management



This form must be completed if you have been injured while on the job and need to see a physician.  Complete the employee portion of the form, sign and date it and turn both pages into your building Administrative Secretary immediately.  This form must be completed and turned in prior to a visit to the physician.


This form must also be completed if you, as an employee, have been injured on the job AND do not intend to see a physician.  Complete the form and turn it into your building Administrative Secretary.

This form must be used for ANY student who is injured.  Please complete the form in its entirety and turn it into your building Administrative Secretary. 

Questions?
Contact Cyndi Turner
(503) 825-5046