Welcome to Incident Reporting Portal

When an injury occurs, the following steps should be taken:

  1. The injured employee will report the injury to their supervisor.
  2. The injured employee will complete the Injury Report Form.
  3. The supervisor will communicate with the Environmental Health and Safety (EHS) team to alert them that there has been an injury.
  4. The supervisor will help arrange for the employee to receive local medical care.
  5. The supervisor will print out the Medical Provider Packet including the Medical Release Form for the employee to take with them to the treatment facility or doctor’s office.  These forms will be given to the treating provider to complete.
  6. The supervisor will work with EHS to complete the Incident Investigation Report Form.
  7. The supervisor will submit the Injury Report Form completed by the employee, the Incident Investigation Report Form, and the completed Medical Provider Packet Forms to KTA for physician review.
  8. The KTA physician will follow up with the supervisor after review of the documentation.
Injury Report Form

Incident Investigation Report Form

Medical Release Form

Incident Reporting Form

To complete the application process, please ensure you fill out the following fields: full name and email contact information. Additionally, it is required to upload three essential documents: Injury Report Form, Incident Investigation Report Form, and Medical Release Form. Each document must be in an accepted PDF format and clearly legible. Failure to provide any of these documents or to complete the necessary fields may result in a delay in the processing of your application.