An injured employee must immediately report any injury to his/her principal/supervisor. At the time an injury is reported, the principal/supervisor should direct the employee to the school nurse to complete an Injury Report form. An injured employee is required to complete the packet of Workers' Compensation forms as soon as possible. Please include names of witness(es) to the accident or injury.
All injury reports must be sent in a timely manner to Amy Houtz in the Business Office to report to the workers compensation carrier, UPMC Work Partners. Please feel free to contact her at 355-5516 (ext. 3106) or firstname.lastname@example.org with any questions or concerns.
The above documents are in PDF format. To view the PDF form you must have Adobe Acrobat or an equivalent PDF viewer for the document(s) to be viewed. Adobe Acrobat Reader is a free program that can be downloaded on the Adobe website.