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Non-Employee Incident/ Injury Report - Texas Tech University ... - ttuhsc

Non-Employee Incident/ Injury Report - Texas Tech University ... - ttuhsc 2026

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The document is a Non-Employee Incident/Injury Report Form for Texas Tech University Health Sciences Center, designed for reporting injuries or incidents occurring in non-clinical areas. It requires detailed personal information of the injured party, specifics about the incident, and witness details. The form must be completed thoroughly and submitted to the Department of Safety Services within 72 hours.

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Click ‘Get Form’ to open it in the editor.
Begin by filling out the 'Personal Information' section. Enter your title, full name, date of birth, sex, and status (Student, Visitor, or Volunteer). Provide your home address and contact information.
In the 'Incident / Injury Details' section, specify the date and time of the injury. Describe the injury in detail and explain how the incident occurred. If necessary, use our platform's drawing tools to create a diagram illustrating conditions at the scene.
Indicate which campus the incident occurred on and provide the name/address where the injury took place. Confirm whether medical treatment was required by selecting 'Yes' or 'No'.
Complete the 'Name of Witness / Name of Preparer' section by entering details for witnesses and supervisors involved. Ensure you include signatures where required.
Review all entries for accuracy before submitting your report within 72 hours to the Department of Safety Services.

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We have answers to the most popular questions from our customers. If you can't find an answer to your question, please contact us.

What is an employee accident report?

A work incident report is the formal documentation of specific details that describe the events of a workplace incident, such as an accident or injury. Its purpose is to discover the causes and events occurring in an accident or injury with the goal of preventing accidents in the future.

Can I lose my job due to an injury?

Yes, over time, if the injury means you can no longer be productive and the proper paperwork wasnt submitted for a reasonable accommodations, which might lead to a medical retirement or laid off with unemployment benefits.

What happens when an employee is injured at work in Texas?

Workers compensation insurance can provide income and medical benefits if an employee is hurt while working. Most employers in Texas can decide whether to provide this benefit or not. This section provides information regarding options you may have if you have a work-related injury or illness.

How does workmans compensation work in Texas?

Workers compensation is an insurance program managed by the State of Texas. It provides pay and medical benefits to employees who have a work-related injury or illness. Not all Texas employers provide workers compensation insurance, but most do.

What constitutes an injury report?

An Injury Report is a formal document used to record details about an individuals injury, accident, or incident. It serves as a critical tool for documenting workplace injuries, facilitating timely reporting, initiating investigations, and ensuring compliance with legal and regulatory requirements.

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