Medical Center Employee Relations Forms

Medical Center Performance Management Program

Medical Center HR Forms


FMLA / Leave of Absence
Short Term Disability
Workers' Compensation Forms
The following report (Incident/Injury) must be completed along with the report pertaining to it ex: Body Fluid Exposure, etc.  Please send to Frances Toole at or fax to 1-0882.  Also include a copy to your manager.

Incident/Injury Report

Body Fluid Exposure
Chemical Exposure
Bruise / Contusion / Abrasion
Dermatitis / Rash
Fall / Slip / Trip
Infectious Disease
Laceration / Cut
Sharps / Needle Stick - Clean
Sharps / Needle Stick - Used
Other Exposure
Strain / Sprain
Witness Statement