SOP 104.22-att-2: Notice of Injury and Leave Election Form

Division:
Administrative & Finance
Effective Date:
May 27, 2020
Reference Code:
IVO04-0002
Topic Area:
104 Policy-HR Records/I.D./Criminal History
PowerDMS:
View on PowerDMS
Length:
20 words

Summary

This form is used to document employee injuries and record the employee's election regarding leave options following a workplace injury. The completed form is retained permanently in both the employee's official HR file and local HR records to maintain a complete record of the injury and leave decisions made by the employee.

Key Topics

  • workplace injury
  • employee injury form
  • leave election
  • injury documentation
  • HR records
  • workers' compensation
  • employee leave options
  • injury reporting
  • personnel files
  • record retention

Full Text

SOP 104.22
Attachment 2

5/27/20

Record Retention: Upon completion, this form shall be retained permanently in the employee's official and local HR files.

Attachments (2)

  1. Employee Incident Notice (617 words)
  2. Notice of Injury and Leave Election Form (20 words)
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