General Liability Claims/Incident Report Form

When an injury occurs, the first priority is taking care of immediate medical needs.  For emergencies call LSU Police:  225-578-3231

Use this form to report all incidents that resulted in an injury or had the potential to cause an injury to others on University property or at a University activity or event.  (For auto accidents use the Auto Accident Report form.)

Faculty, Staff, Graduate Assistants, Student Workers

All employees who are reporting a work related incident/injury involving an LSU employee should follow the protocol outlined on the Workers Compensation page. 

This form should be completed by the LSU department that experienced or has been made aware of an incident that resulted in, or may have resulted in, an injury to a non-employee.

Third parties should complete their reporting form to file a claim. 

 Submit this form immediately.  Entries with an asterisk (*) must be completed in order to submit the form.  When finished, click the "submit" button.  LSU Safety, LSU Risk Management, or the University's Claim Administrator will respond to the report as needed.