Texas form 2026

1. Click ‘Get Form’ to open the Sharps Injury Form in the editor.
2. Begin by filling out the Employee Information section. Enter your name, gender, date of birth, home telephone number, and address. Ensure all details are accurate for proper identification.
3. Next, provide your present classification and how long you have been employed at UTD. Include your social security number and weekly pay/salary for record-keeping purposes.
4. In the Vaccines Received section, document any relevant vaccinations along with their dates to ensure health compliance.
5. Proceed to the Injury Information section. Clearly state the location of the accident, date and time it occurred, and specify the type of sharp involved in the incident.
6. Fill in additional details such as brand name, model number of the sharp object, job classification of the injured person, and original intended use of sharps.
7. Finally, enter your supervisor's name and phone number. Don’t forget to sign and date the form before submission.

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