Online First Report of Injury
You don't have to register.
Enter your policy number and much of your organization's information will be pre-entered for you.
The online form asks for the same information the
paper form requires. Be as complete and as accurate
as possible. Double check that what you have typed is accurate.
Be sure to complete all the blue fields. They are required. The First Report cannot be accepted if all
blue fields are not complete.
Click to view sample page
Use the "Confidential comments " box if you suspect
the injury is not work related or if you have other concerns. Your
comments will go to your SFM claims representative. They will not appear on the actual
First Report, which
the injured employee receives
a copy of.
Click to view sample page
View the completed First Report of Injury form.
You can print a copy or save it on your computer.
You can also print out a confirmation. This notice
is proof you reported the injury. Save it with your
claims files.
Click to view sample page
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