Employee Injury/Illness Report

EMPLOYEE'S REPORT OF INJURY/ILLNESS 
‚Äč(Form to be completed by Supervisor Only) 

Please return form to Benefits Coordinator: Micky Martinez


Where to send Employees when they have an accident and need medical treatment:

 If an emergency they can go to any emergency room!

Workers Comp Doctors Available to you:

 NOVA                                     St. Joseph Occupational Medicine

2001 S. Texas Ave.                  2010 East Villa Maria Road

Bryan, TX 77802                      Bryan, TX 77802

979-599-5900                           979-821-7373

Fax 979-599-5901

(Free Transportation)