Employee and non-employee incident report

For life-threatening incidents, please call 911 immediately. 

ASU Environmental Health and Safety reviews emails and web-based messages during business hours – Monday through Friday from 8 a.m. to 5 p.m. 

Outside of business hours, please call the ASU Police Department for assistance at 480-965-3465.

Is the injured person an
Was a workmen's comp claim filed?

When an ASU employee is injured or becomes ill from a work-related incident, fill out the Workers Compensation report and supervisor's investigation packet

Forward completed forms to the Office of Human Resources at mail code 5612 or fax to 480-965-1971

Where did the incident occur?
format: xxx-xxx-xxxx