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Report Forms

Injury, Illness, or Incident Reporting

Forms

WVU Employee Injury/Incident Report - To be completed by the supervisor to report the injury/occupational illness of an employee. Form must be completed within 24 hours or first working day after incident.

WVU Student/Visitor Accident Report Form - To be completed by the student or visitor to report an injury. Form must be completed within 24 hours and printed, signed, and emailed to address on form.

Incident Report Form - Complete this form when an incident or "near miss" having the potential of causing injury or property damage has occurred at the Health Sciences Center.

Return to Work Notice - To be filled out by the supervisor when employee returns after being on leave due to an injury/occupational illness.


The Medical Management Unit administers and coordinates WVU medical leave programs. This unit was established to protect the confidentiality of employee’s medical information. All required medical documentation should be provided directly to and housed in Medical Management.If you have any safety issues, concerns, or questions please contact the Safety Department
by clicking HERE or by phone at: (304) 293-0952.

WVU Medical Management (http://medicalmanagement.hr.wvu.edu/home) When you click on Medical Management it will take you to their webpage

The Unit also serves as a starting point in the filing of Short- and Long-Term Disability claims, although these insurance plans are managed by WVU Employee Benefits. All required medical documentation related to Short and Long-Term Disability claims should be provided directly to and housed in the Medical Management Unit where confidentiality will be protected and maintained.