Workers Compensation
FORMS
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Admittance Form (3-WC)
This form is to be filled in by the supervisor and taken to the Center
for Occupational Health by the employee for the first visit only.
Employee Incident Report
(5-WC)
To be filled in by employee and supervisor within 24 hours of an
accident or injury.
OSHA Form 301
This form helps the employer and OSHA
develop a picture of the extent and severity of work-related incidents,
file this report if the
doctor has you off work or on restricted duty due to the injury.
Adobe Acrobat (PDF) Reader download
page:
http://www.indstate.edu/oit1/readers/acrobat/