Work-Related Injuries and Illnesses

Employee’s Report of Injury Form

Primary Physicians Panel Form

Employees who have a work-related injury or illness should notify their supervisor as soon as possible.

• If the injury is life-threatening, call 911.
• If it is a medical emergency, please proceed to the nearest Emergency Department.
• If you need medical treatment, please print and complete the Employee’s Report of Injury form and choose a provider from the Panel of Physicians form. Please fax both forms to the Occupational Health Department at fax number (757) 446-7188.

If you have questions regarding a work-related injury or illness, please call the Occupational Health Department at (757) 446-5870.

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