East Lansing, Michigan 48824-1316 - oem msu-2025

1. Click ‘Get Form’ to open it in the editor.
2. Begin by entering the affected employee's personal information, including their name, age, and contact details. Ensure accuracy as this data is crucial for tracking occupational diseases.
3. Next, provide the employer's information. This includes the company name, work site address, and the number of employees at the facility. This helps in identifying trends related to specific industries.
4. In the illness section, detail the diagnosis or clinical impression using appropriate codes from the International Classification of Diseases (ICD). Be thorough to ensure proper categorization of the reported condition.
5. Finally, review all entered information for accuracy before submitting. Utilize our platform’s features to save your progress and make any necessary edits easily.

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