Email Instructions to Report a Work-related Injury, Illness or Death

As required by Title 8 regulations, section 342, you must include the following information, if available, in your email message:

  1. Time and date of accident/event
  2. Employer's name, address and telephone number
  3. Name and job title of the person reporting the accident
  4. Address of accident/event site
  5. Name of person to contact at accident/event site
  6. Name and address of injured employee(s)
  7. Nature of injuries
  8. Location where injured employee(s) was/were taken for medical treatment
  9. List and identity of other law enforcement agencies present at the accident/event site
  10. Description of accident/event and whether the accident scene or instrumentality has been altered.
  11. Email your report and the above information to:
October 2019