Vermont first report injury 2026

1. Click ‘Get Form’ to open the Vermont First Report Injury in the editor.
2. Begin by entering the employer's legal name in the designated field. Ensure accuracy as this information is crucial for processing.
3. Fill in the business name and mailing address, including street number and zip code. If the location differs from the mailing address, provide that information as well.
4. Input the telephone number along with an extension and contact person for any follow-up inquiries.
5. Complete employee details: last name, first name, middle initial, social security number, date of birth, home address, and phone number.
6. Indicate whether you regularly employ 10 or more employees by selecting 'Yes' or 'No'.
7. Document the accident details: date of accident, time of accident (AM/PM), location of accident, and a description of how it occurred.
8. Describe the injury sustained by the employee and indicate if there was any lost time from work due to this incident.
9. Finally, ensure all sections are completed accurately before signing off as the employer or representative.

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