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Injury Report

Universal Intermodal » Injury Report

Injury Report

  • Before submitting this report please contact the Safety Department immediately if the injury is serious or a death has occurred so we may help with the situation as soon as possible. All hospitalizations, loss of eye or appendage are OSHA regulated for notification. Otherwise complete this report as soon as you can but no later than 8 hours after the injury or illness (whether medically treated or not), which arise out of, or in the course of the individuals work.

    All medical paperwork from the individual must be emailed to:
    injuryupdates@goutsi.com

  • Person Completing This Form

  • Injured Person

  • Injury Information

  • Please list all witnesses.
  • Eg. Strained Right Elbow, Bruised Left Leg.

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