Incident Report • CampusOptics

University of Texas at Tyler ~ 3900 University Blvd. ~ Tyler, TX 75099

The injured employee, supervisor or designee is advised to notify the UT Tyler Risk Management office regarding the injury at 903.877.7743 or email wci@uttyler.edu about the incident.

Employees are required to report all injuries/illnesses within twenty-four (24) hours, even if they do not need medical attention.

Please also complete the Employee’s First Report of Work-Related Injury or Occupational Disease form for our Risk Management Office. Click Here

Reporter Info

Email* Required

Phone Number* Required

First Name* Required

Last Name* Required

Location

Campus, Building, or Outdoor Area* Required

Additional Location Details

Exact Location

Loading…

General Incident Form

Occurred At* Required

Is the person involved in incident a student, faculty, staff, or a contractor?* Required

Full name of person involved in incident* Required

Please describe the incident* Required

Were there any injuries?* Required

If yes, describe injury

Was there any property damage?* Required

If yes, please describe the damage

What steps, if any, have been taken to reduce the chance of this happening again?

Add Supporting Documents

Add files to upload as supporting documentation along with your incident report.