Occupation/Injury Illness & Patient Visit Forms  

Report an Injury or Illness

 

If you are injured at work, you must:

  1. Seek treatment at your campus' Occupational Health Clinic, Employee Health Clinic or a Banner Emergency Department
     
  2. Fill out an Injury/Illness Report Form and return it to the appropriate party.

Important Information Regarding Exposure Injuries

  • Blood or Body Fluid Exposure Information [do we need this link? must be external.]
     
  • ARIZONA ONLY: In the event of a blood or body fluid exposure, contact the Post Exposure Prophylaxis (PEP) Hotline at (602)747-8364. PEP provides exposure analysis and referral to Occupational Health as outlined in the Bloodborne Pathogen Exposure Control Plan.

Alaska
Arizona

California

Colorado

Nebraska

Nevada

Wyoming

Note: Some locations have the option of using an online form or paper form. The online form is the preferred method. Be sure to submit the correct form for your state.  

For Employees
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