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Work Injury Form (DWC-1)

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  • Create Date September 9, 2022
  • Last Updated September 9, 2022

Work Injury Form (DWC-1)

DWC 1 and Notice of Potential Eligibility Forms

Work Injury Form (DWC-1)

Complete this form to report all work injuries and submit to HR within 24 hours of injury. If you do not wish to complete this form or seek treatment, please complete an Employee Declination form. Contact HR for any questions regarding work injuries.