Forms

Workers’ Compensation Incident Report Form

In addition to the incident report form above, the following workers’ compensation forms are required for certain locations.

For California employees, California Division of Workers’ Compensation

For Maine employees, Maine Workers’ Compensation Board

For North Carolina employees, North Carolina Industrial Commission

For Ontario employees, WSIB

Resources for Washington State employees: Department of Labor & Industries 

Vehicle Accident Report Form

Incident Report Form

Department Property Damage Claim Form

Student Property Damage Claim Form

Email completed reports to risk@northeastern.edu