Reporting An Accident or Injury via the Web

If the Nurse Triage hotline is out of service, “incidents” (accidents or injuries) can be reported online.

Clicking on the red button below to Report an Incident will take you to an online incident reporting form. Completing this form will create an Accident/Incident Report that will be sent to your supervisor.

If you were injured during a workplace accident or incident, be sure to select “Yes” when the form asks you if you have sought, or intend to seek, medical care. Doing so will initiate a claim for workers’ compensation benefits.

NOTE:  To complete the process you must click the COMPLETE INCIDENT button and then confirm you “are ready to complete this incident” by clicking OK to the pop up message.  Your data will be lost if you close your browser without performing these final steps.

To save or share this report, please use this link.

Questions? Call us at (425) 917-7638.

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