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Forms and Resources

This page serves as your gateway to essential Saint Louis University risk management resources and forms, designed to efficiently address and document various incidents and requirements. Direct links are provided for easy access to these SLU forms and resources.

Employee Health

Report an Injury to an Employee

This report documents the details of a workplace injury, including the injured person, the nature of the injury and the incident's circumstances. It is used for insurance, legal and safety purposes.

Report an Employee Injury

Employee Authorization Form

The Employee Authorization Form must be completed by an injured employee’s supervisor or the Office of Risk Management and Insurance and should be taken to Concentra Urgent Care at 3100 Market St., St. Louis, MO, 63103, when the employee receives treatment, facilitating the workers' compensation process and ensuring timely and appropriate handling of the injury claim.

All workers' compensation treatments are to be performed at Concentra Urgent Care's Market Street location only.

The Telemedicine Quick Start Guide is a guide to Concentra’s telemedicine platform designed specifically for the treatment of relatively minor, work-related injuries. It uses video technology to deliver health care to you when and where you need it using a smartphone, tablet or computer. 

 

Employee Medical Records

To request copies of an employee's medical records, please complete the linked form. We kindly request that you allow up to seven business days for the processing of your records retrieval.

Request Medical Records

Other Injuries

Adverse Medical Incidents

This report is used to document adverse incidents or events that occur within a medical or health care setting. This serves as a structured mechanism for healthcare professionals and staff to report any unexpected or undesirable occurrences related to patient care, medical procedures, or the healthcare environment.

Report an Adverse Medical Incident

Injury to a Non-Employee

This report is used to document incidents involving individuals who are not employees of the university but are present on university premises or involved in university-sponsored activities. This serves as a tool to collect information about incidents, accidents, or other occurrences that may impact the safety or well-being of non-employees, such as visitors, guests, contractors, or event attendees.

Report an Injury to a Non-Employee

Needle Sticks, Bloodborne Pathogens Exposure and Injury

This protocol is designed to prevent infectious diseases and disabilities for students by ensuring they receive prompt evaluation and treatment following an exposure or injury.

 

University Vehicles and Property

Damage or Theft of University Property

This report is used to document incidents resulting in the loss of University property.

Report Damage and/or Theft

Golf Cart Rules and Regulations

The Golf Cart Rules and Regulations outline essential safety protocols and operational guidelines for faculty, staff, and students authorized to drive golf carts on campus. These rules ensure safe, efficient, and responsible use of golf carts in accordance with university policies.

Golf Cart and Utility Vehicle Rules and Regulations (PDF)

 

Motor Vehicle License Registration Check

The Motor Vehicle License Registration Check (MVLRC) form should be completed by any faculty, staff or student who wishes to operate a university vehicle. It serves to verify that individuals have valid licenses, ensuring compliance with safety regulations and maintaining eligibility to drive university-owned or rented vehicles.

Complete a Motor Vehicle License Check (MVLRC)

 

Vehicle Accident Report

The Vehicle Accident Report is a document used to report the details and events related to vehicle accidents involving a university-owned vehicle, any employee-owned vehicle used on official University business, or any vehicle rented or leased by or for the University. The University requires drug and alcohol screening for all accidents or injuries during an employment-related accident. See the procedures here.

Note: Do not use this form to report employee injuries. If an injury occurs because of a motor vehicle accident, the employee must also fill out an employee report of injury.

Report an Accident in a University-Owned Vehicles

 

Travel

International Medical Travel Guide

The International Medical Travel Guide is for faculty/staff traveling internationally to provide information related to the latest travel information and security, health information, and additional support related to international travel.

International Travel Guide (PDF)

Guide for Medical Care While Traveling

When traveling domestically or internationally, the travel assist guide provides information related to 24/7 medical coverage while traveling for full-time employees of the University.

Travel Assist Guide (PDF)

Certificates and Proof of Insurance

Third-Party Certificate of Insurance 

The Certificate of Insurance Request serves as a means for individuals or departments to request Certificates of Insurance when entering into agreements with third parties.

Request a Third-Party Certificate of Insurance

Proof of Medical Professional Liability Insurance

This request form is intended for current medical professionals employed by the University to acquire proof of Medical Professional Liability insurance. Additionally, it serves as a mechanism for collecting essential information from individuals requiring verification of such coverage. Please select "Proof of Medical Professional Liability Insurance" from the options provided under the "Type of Certificate" section.

Request Proof of Medical Professional Liability Insurance

Claims History Requests

This form serves as a means for medical credentialing offices, practitioners, and hospitals to request claims histories on individuals that have applied/reapplied for staff membership, clinical privileges and/or permission to provide services at a facility. The form serves as a tool to collect necessary information about individuals requiring information for medical credentialing.

Request Claims History

Events

Risk and Release of Liability Waiver

The Risk and Release of Liability Waiver is a legal document that individuals sign to acknowledge and accept any potential risks associated with participating in certain activities or events. By signing, they agree to waive their right to hold the organization liable for any resulting injuries or damages.

SLU Risk and Release of Liability Waiver (Fillable PDF)

Food Truck Guidelines

This document outlines the rules and regulations to ensure the health and safety of our community, protect our facilities and maintain compliance with insurance, liability and health codes while maintaining an orderly location and operation of food trucks.

Food Truck Rules and Regulations (PDF)

 

Outdoor Grilling on Campus

These guidelines provide detailed information for University departments, chartered organizations and groups wanting to grill outside as part of a University-sponsored event. Strict adherence to these guidelines is mandatory in order to protect University property and participants of a University-sponsored event.

Outdoor Grilling on Campus (PDF)

 

Tailgating Guidelines

This document provides the framework for employees, students and visitors who wish to tailgate before or after a University-sponsored event. The purpose is to enhance the event experience while promoting a safe environment and preserving the beauty of the campus.

Tailgating Guidelines (PDF)

Car Smash Events

These guidelines focus on safety, responsibility, and compliance and are provided to ensure the safety and success of the event. All participants, volunteers, and spectators must adhere to the following safety measures while participating in a car smash event.

Car Smash Guidelines (PDF)

Dunk Tanks

This guide provides direction for any chartered student organization or recognized groups or department wanting to have a dunk tank as part of an event. The guidelines focus on safety, responsibility and compliance to ensure the safety and success of the event.

Dunk Tank Guidelines (PDF)

For additional information related to any of the above resources, please reach out to the Office of Risk Management and Insurance at riskmgmt@health.slu.edu.