Form should be completed within 24 to 48 business hours of injury or illness. Injured person may be contacted for additional information. See Employee & Student Blood and Body Fluid Exposure for additional information.

Use this link for non-emergency issues including physical discomfort (temperature, humidity, musty, stagnant or stale air, particulates or dirt coming from the HVAC diffusers, etc.)

• For emergencies, seek immediate medical attention.
• Report Injury/Illness to your supervisor immediately or within 24 hours.
• Review procedures for Employee Work-Related Injuries at
  https://www.uta.edu/campus-ops/ehs/workerscomp/index.php

Report all non-emergency safety concerns to EH&S, including but not limited to:

• Near miss: close calls with potential to cause accident or property damage, e.g.,
  - laboratory equipment failure,
  - non-compliance with safety policies or procedures,
  - general unsafe workplace conditions that may result in an accident if the conditions are not addressed.
• Environmental concerns
  - strange ponding of water
  - discolored area of grass around a transformer
  - oil/gasoline flowing directly into a waterway on campus, etc.