Workers' Compensation Forms

Supervisor's Report of Injury

1. Download form to computer

2. Fill out form in Adobe

3. Print Form

4. Supervisor signature is required

5. Supervisor send form to ehs@txstate.edu & kb1569@txstate.edu

For questions please call Katherine Beamer at 512-245-3616

Authorization for Release of Information

Employee's Report of Injury

Request for Travel Reimbursement

Witness Statement

Employees Election Regarding Utilization of Sick and Annual Leave

Medical Reimbursement Request Form

SORM/CareWorks Network Acknowledgement Form