HR Forms

What to do if an accident occurs in Animal Science facilities or at an Animal Science-Sponsored Event

If the individual is a University of Nebraska-Lincoln employee

  1. If the individual needs medical attention, call 911 or make appropriate arrangements.
  2. Fill out First Report of Alleged Occupational Injury or Illness, Workers' Compensation Incident Report, along with the Employee's Choice or Change of Doctors Form. All forms need to be turned in to Deb DeWald (Room C201) immediately. If the injury occurs on a weekend or after hours, the Department Head needs to be notified as soon as possible.


Incident Report – Injury/Property Damage for non-employee (including students)

  1. If the individual needs medical attention, call 911 or make appropriate arrangements.
  2. Fill out Injury/Property Damage Report and turn in to Deb DeWald (Room C201) immediately. If the injury occurs on a weekend or after hours, the Department Head needs to be notified as soon as possible.


Automobile Accident

  1. If the individual needs medical attention, call 911 or make appropriate arrangements.
  2. Fill out Vehicle Accident report and turn in to Deb DeWald (Room C201) immediately. If the injury occurs on a weekend or after hours, the Department Head needs to be notified as soon as possible.

All forms can be obtained from the list below or from Deb DeWald in C201 or in the Administrative Office, C203.

Workers' Compensation Forms

Please note that all four documents below are to be filled out for each claim.

First Report of Alleged Occupational Injury or Illness  PDF (104 kb)

Workers' Compensation Incident Report  PDF (80 kb)

Employee's Choice or Change of Doctor Form  PDF (106 kb)

Release to Return to Work  PDF (91 kb)

Vehicular Damage Forms

Vehicle Accident Report  PDF (102 kb)

Private Injury/Property Damage Forms

Injury/Property Damage Report  PDF (75 kb)