Occupational Injury/Illness Report

To file an occupational injury/illness report, please download the document, print out and complete the form and have it signed by both the employee and the supervisor. Return the form via fax or email a scanned copy to both:
Dina Leinweber at dina.leinweber@case.edu or fax # 368-8690
Felice Porter at felice.porter@case.edu or fax # 368-2236.