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Required Reporting Forms

The injury packet forms should be completed and emailed to workerscompensation@uta.edu within 24 hours of the injury. If immediate medical treatment is required, these forms may be submitted as soon as practical after medical treatment has been provided.

The following forms are included in the injury packet:

• - Give to medical provider.
  
  
•  - Complete and sign form as soon as possible after the injury.
  
  
•  - Complete and sign. (/)
  
  
•  - Please read. (/)
  
  
•  Complete and sign.
  
  
• Choose  form or .
  
  
•  - If one or more workdays are lost due to injury, complete and sign.
  
  
• - Complete and sign.