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Employers First Report of Injury or Illness Form

Fill out the form to download this resource.

Use this free template as your Employers First Report of Injury & Illness. This template works for state-level mandatory reporting as well as general recordkeeping and workers compensation claims management.

This comprehensive form makes it easy to complete your First Report of Injury or Illness online: add your electronic signature, mark the simple check boxes, and enter all required information. It has all of the data fields you need to document a workplace injury or illness for compliance.

Speed up your workflow by quickly filling out and saving each new report, then attaching to email to get it to the right people in your organization and right regulatory agency, fast.

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