Worker's Comp. Notification of Injury Report Form

 
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  Worker's Comp. Notification of Injury Report Form
   
  The District is subject to fines for late submission of injury reports. This submission will notify the Business Office of your injury. Please complete the information below. The Business Office will follow up with your Supervisor to be sure your signed completed Employee Injury Report Form is submitted to Worker's Comp. within 10 days of your injury.
   

 
 
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