Resources
Worker's Comp Forms
- Employee's Work Injury And Illness Report
- Employer's First Report of Injury or Disease
- Supervisor's Report Form
- Witness Statement Form
Do not transmit the above three forms via e-mail as they contain confidential information.
Risk Management Forms
- Agent Liability Request Form
- Certificate of Coverage
- Coverage Request of Borrowed Items Form
- General Accident Report
- Vehicle Accident/Incident Report Instructions
- Lightning Loss - Affidavit
- Proof of Loss Form
- Hold Harmless
- Vehicle/Equipment Use Agreement and Authorization Form
- Personal Protective Equipment (PPE) Hazard Assessment and Analysis
- Facility Use Agreement
Alumni Center – lower level
Ambrose Health Center – room 1017A
Andersen Hall – HelpDesk, room 200
Arey/Fricker Hall – first floor link
Benson Hall – 1st floor lobby
Bookstore – lower-level lobby
Bigelow Hall – 1st floor lobby
Center of the Arts – lower-level room 32
Center of the Arts – 1st floor atrium elevator
Center of the Arts – room 2052
Clem Hall – 1st floor lobby
Community Engagement Center – room 105
Drumlin Hall – 2nd floor stairs
Esker Hall – 2nd floor lobby
Fischer Hall – 1st floor lobby
General Services – stores
General Services – room 118
Goodhue Hall – lower-level outside of room 20
Goodhue Hall – 2nd floor outside of room 213
Heating Plant – washroom
Heide Hall – 3rd floor elevator
Heide Hall – 1st floor elevator
Hyer Hall – room 330
Hyland Hall – room 1303
Knilans Hall – 1st floor lobby
Laurentide Hall – 1st floor elevator
Laurentide Hall – 3rd floor elevator
Lee Hall – 1st floor lobby
Mary Poppe Chrisman Success Center – lower level elevator
McCutchan Hall – 3rd floor elevator
McGraw Hall – entrance #2
Police – squad med bag 42, 44, 46, 48, 49, parking van
Police – west RHO office
Police – east RHO office
Police – Rock County office WC03
Pulliam Hall – 1st floor lobby
Rock County – Allen Hall 1st floor hallway outside library
Rock County – Andrews Hall lower level near room 001
Rock County – Hyatt-Smith Hall first floor hallway near rooms 103-106
Rock County – Wells Cultural Center lower level near gym
Roseman Hall – room 1031
Roseman Hall – room 2015
Student Athletic Complex – lower-level elevator
Tutt Hall – 1st floor lobby
University Center – 1st floor elevator
Upham Hall – room 140
Wellers Hall – 1st floor lobby
Wells Hall – 1st floor lobby
Williams Center – room 100
Williams Center – gym #4 hall
Williams Center – pool hall
Williams Center – 2nd floor lobby
Winther Hall – 2nd floor lobby
Young Auditorium – dance studio hallway
Ambrose Health Center – room 1001
Andersen Hall – HelpDesk, room 200
Arey/Fricker Hall – first floor link
Benson Hall – 1st floor lobby
Bigelow Hall – 1st floor lobby
Clem Hall – 1st floor lobby
Community Engagement Center – room 105
Drumlin Hall – 2nd floor stairs
Esker Hall – 2nd floor lobby
Fischer Hall – 1st floor lobby
Goodhue Hall – main building entrance lobby
Knilans Hall – 1st floor lobby
Lee Hall – 1st floor lobby
Ma’iingan Hall – 1st floor, across from student mailboxes
Pulliam Hall – 1st floor lobby
Rock County – Allen Hall 1st floor hallway outside library
Tutt Hall – 1st floor lobby
University Center – 1st floor elevator
Wellers Hall – 1st floor lobby
Wells Hall – 1st floor lobby
Williams Center – room 100
UW-W employees and students can obtain chemical safety information about products and substances used or stored in the course of business at UW-W. To locate a specific material safety data sheet, search for keywords from the product or manufacturer name to locate the appropriate material safety data sheet. If you are unable to locate the appropriate MSDS for a product that is present in a UW-W facility, please notify your supervisor or faculty member to request a copy.
Access the UW-W Material Safety Data Sheet Collection
Note: after you click on the link above, press the (CTRL) key and the letter "F" to open a search window. Type in a keyword of the product or manufacturer name to search for the MSDS.
Comments or suggestions about the UW-W MSDS collection? Please let us know!
Workstation Ergonomics Information
Other Agencies
Below are the forms to be completed when reporting and requesting insurance reimbursement on a property loss.
- Proof of Loss
- General Accident Report/Property Damage Form
- Lightning Loss - Affidavit (As Needed)
- You will need to provide a copy of your department inventory showing the item you wish to replace or repair and/or a copy of the purchase order or requisition that was used to purchase the item.
- You will need police reports on items stolen or vandalized.
- Submit a quote for the replacement item or estimate of repair for damaged property.
Currently our property loss deductibles are:
- $1000 for damaged or destroyed items
- $1000 for stolen property where forced entry occurred
- $2500 for stolen property where there was no evidence of forced entry.
Send all forms and required documentation to the Risk Management and Safety Office (Hyer Room 330). If you have any questions please do not hesitate to contact our office at 1856.
When travelling abroad in any capacity related to your work at UW-Whitewater, the Universities of Wisconsin expect all faculty and staff to travel with adequate insurance coverage and to follow appropriate data protection protocols with your technology. This includes travel to attend a conference, give a presentation, conduct research or take meetings—it even applies to personal travel with university equipment like your laptop.
Insurance
All employees are automatically covered by basic medical emergency and repatriation insurance owned by the Universities of Wisconsin. This insurance offers advising services, like help finding a doctor, but primarily covers extreme events that require emergency medical evacuation from the country. For policy information and coverage contacts, please contact Lance Fredrick, Risk Management Director.
Employees are also encouraged to purchase travel insurance from CISI, who contracts with the Universities of Wisconsin to provide full-service travel and medical insurance for UW students and employees. For less than $10/wk, it covers many travel and medical situations. It is required for students studying abroad and highly recommended for faculty and staff travelling abroad.
Export Controls
The US Government regulates sensitive science and technology, including how you manage and protect data when oversees. It applies to anyone travelling out of the country for work. For example, almost always employees should travel with a “clean” computer.
On the UWW campus, the Office of Research and Sponsored Programs oversees UWW compliance with these rules.