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This page serves as your gateway to essential risk management resources and forms, designed to efficiently address and document various incidents and requirements. Direct links are provided for easy access to these forms and resources.

• • This report documents the details of a workplace injury, including the injured person, the nature of the injury, and the incident's circumstances. It is used for insurance, legal, and safety purposes.
• Concentra Authorization Form for Employee Injury (PDF)
  • The Employee Authorization Form must be completed by an injured employee鈥檚 supervisor or the Office of Risk Management and Insurance and should be taken to Concentra Urgent Care when the employee receives treatment, facilitating the workers' compensation process and ensuring timely and appropriate handling of the injury claim.
• Concentra Telemedicine Quick Start Guide
  • The Telemedicine Quick Start Guide is a guide to Concentra鈥檚 telemedicine platform designed specifically for the treatment of relatively minor, work-related injuries. It uses video technology to deliver health care to you when and where you need it using a smartphone, tablet or computer.
• • This link provides quick access to a list of convenient Concentra health care locations.
• • This report is used to document adverse incidents or events that occur within a medical or healthcare setting. This serves as a structured mechanism for healthcare professionals and staff to report any unexpected or undesirable occurrences related to patient care, medical procedures, or the healthcare environment.
• Student Needle-Stick, Blood Borne Pathogens Exposure and Injury Protocol (PDF)
  • This protocol is designed to prevent infectious diseases and disabilities for students by ensuring they receive prompt evaluation and treatment following an exposure or injury.
• • This report is used to document incidents resulting in the loss of university property.
• (University-owned vehicles only)
  • The Vehicle Accident Report is a document used to report the details and events related to vehicle accidents involving a university-owned vehicle, any employee-owned vehicle used on official University business, or any vehicle rented or leased by or for the University. The University requires drug and alcohol screening for all accidents or injuries during an employment-related accident. See the procedures here.
    
    Note: Do not use this form to report employee injuries. If an injury occurs because of a motor vehicle accident, the employee must also fill out an employee report of injury.
• (MVLRC)
  • The Motor Vehicle License Registration Check (MVLRC) form should be completed by any faculty, staff or student who wishes to operate a university vehicle. It serves to verify that individuals have valid licenses, ensuring compliance with safety regulations and maintaining eligibility to drive university-owned or rented vehicles.
• Golf Cart Rules and Regulations (PDF)
  • The Golf Cart Rules and Regulations outline essential safety protocols and operational guidelines for faculty, staff, and students authorized to drive golf carts on campus. These rules ensure safe, efficient, and responsible use of golf carts in accordance with university policies.
• • This report is used to document incidents involving individuals who are not employees of the university but are present on university premises or involved in university-sponsored activities. This serves as a tool to collect information about incidents, accidents, or other occurrences that may impact the safety or well-being of non-employees, such as visitors, guests, contractors, or event attendees.
• • The Certificate of Insurance Request serves as a means for individuals or departments to request Certificates of Insurance when entering into agreements with third parties.
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  • This request form allows individuals to obtain evidence of Medical Professional Liability insurance. It also serves as a tool to gather necessary information from those needing proof of such coverage. Select Proof of Medical Professional Liability Insurance under Type of Certificate.
• International Assistance Travel Guide (PDF)
  • The International Medical Travel Guide is for faculty/staff traveling internationally to provide information related to the latest travel information and security, health information, and additional support related to international travel.
• Travel Assist (PDF)
  • When traveling domestically or internationally, the employee guide provides information related to 24/7 medical coverage while traveling.
• 麻豆视频下载 Risk and Release of Liability Waiver (Fillable PDF)
  • The Risk and Release of Liability Waiver is a legal document that individuals sign to acknowledge and accept any potential risks associated with participating in certain activities or events. By signing, they agree to waive their right to hold the organization liable for any resulting injuries or damages.

For additional information related to any of the above resources, please reach out to the Office of Risk Management and Insurance.