Report an Injury, Safety Concern, or Near-Miss

Injuries, safety concerns, and/or near-misses occurring on campus or while participating in university business should be reported within 24 hours.

If you or your employee experiences a serious injury that requires a trip to the hospital, please contact EHS immediately at 949-824-6200.

  • During business hours, press 1 to be connected to the front desk.
  • After hours and on weekends, press 2 to be connected to an EHS responder.

For Campus Employees (excluding Facilities Management and UCI Health)

For UCI campus employees (staff, students, faculty), please complete the form below.

You may also contact Workers’ Compensation at wcdm@uci.edu or go to the UCI HR workers’ compensation webpage for assistance.

For non-vehicle property damage ONLY, review Risk Services' Claims Management webpage for more information.

Campus Resources

Facilities Management Employees

Facilities Management employees are required to use the RSS portal, ONLY for injury/illnesses submissions.

Facilities Management Injuries/Illnesses RSS Portal

UCI Health Employees

UCI Health employees, at any UCI Health site, should report through the UCI Health SQIS. Contact UCI Health HR for more information.

UCI Health Safety and Quality Information System (SQIS)

Reminder this form requires UCI credentials. If you do not have UCI credentials, please email safety@uci.edu.

Please complete the following and click CONTINUE.
If more than one person was injured, please submit a report for each person.

 

1. Select the information that best describes the nature of the incident:



 

2. What is the affiliation of the person for whom this form is being completed?

      
      
      
      

 

3. Was a vehicle involved?   

            

 

4.  If a vehicle was involved, was it? (choose one):