Reporting Procedures
EMPLOYEE IS INJURED
If Injury results in death or overnight hospital stay call IPEP immediately at 800-382-8837.

COMPLETE FORMS AND SUBMIT TO IPEP
1. FIRST REPORT OF INJURY(Completed by Employer)
2. SUPERVISOR'S INCIDENT REPORT(Completed by Employer)
3. MEDICAL AUTHORIZATION FORM(Completed by Employee)
[email protected]fax 765-868-3310

IS TREATMENT REQUIRED?

