Environmental Health Services
Colorado State University
141 General Services Building
Ft. Collins, CO 80523-6021
Ph: 970-491-6745
Fax: 970-491-4804
email: EHS@ColoState.edu

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Workers' comp home


Online First Report of Injury & Workers' Compensation

Initial Online First Report of Injury Requirements

  1. Employee's Statement Part I.

    An employee who is injured or suffers an occupational disease as a result of a job must submit an online form (First Report) within 4 days. Failure to do so can result in the loss of one day's benefits for each day's failure to report. The employee is to complete the online form and submit it to their Departmental Designated Person.

  2. Departmental Designated Person Section Part II.

    The Departmental Designated Person (DDP) will receive an email notification of the injured employee submission. Once notified the DDP should log into the EHS Workers' Comp. Site to review the employee's statement and complete the required departmental section and submit the completed form to EHS.

The employee's Departmental Designated Person must review the information provided for accuracy, giving special attention to contributing conditions or circumstances which led to the accident/exposure.



Health Care Providers Contacts
Print Contacts

Work Comp. Health Care Providers Contacts

Walk-In Urgent Care, Appts & Testing

Concentra

2620 East Prospect Road, Suite 160
Fort Collins, CO
(970) 221-5811
Mon-Fri, 8:00am - 6:00pm
Website
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Walk-In Urgent Care, Appts & Testing

General Care Medical Clinic

620 South Lemay Ave.
Fort Collins, CO
(970) 482-6620
Mon-Fri, 8:00am - 7:00pm Sat, 9:00am - 5:00pm Sun, 10:00am - 2:00pm
Website
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Walk-In Urgent Care, Appts & Testing

WORKWELL

1608 Topaz Drive
Loveland, CO
(970) 593-0125
Mon-Fri, 8:00am - 5:00pm
Website
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Walk-In Urgent Care, OHS, Appts & Testing

Poudre Valley Hospital Emergency Dept

1024 South Lemay Ave
Fort Collins, CO
(970) 495-7000
24 hours, 7 days per week
Website
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Walk-In Urgent Care, OHS, Appts & Testing

Poudre Valley Hospital Occupational Health Services

4674 Snow Mesa Drive, Suite 200
Fort Collins, CO
(970) 495-8450
Mon-Fri, 7:00am - 6:00pm
Website
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Walk-In Urgent Care, OHS, Appts & Testing

Poudre Valley Hospital Occupational Health Services

1025 Pennock Place
Fort Collins, CO
(970) 495-8450
Mon-Fri, 8:00am - 5:00pm (closed from 12 Noon to 1:00 PM daily)
Website
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List of Departmental's Designated People

Select a specific Department to narrow the list.



Designated PersonDeptDept CodePhone Num
Siefken, DianeApartment Life8043 (970) 491-4751
Gutierrez, JustineApartment Life8043 (970) 491-4736
Gehrke, CarolAsian/Pacific American Student Services8018 (970) 491-2324
Castor, LindaAsian/Pacific American Student Services8018 (970) 491-1653
Sonday, LoraBiomedical Sciences-Physiology1680 (970) 491-7203
Marshall, JanetBiomedical Sciences-Physiology1680 (970) 491-6760
Solomon, KarenBiomedical Sciences-Physiology1680 (970) 491-5036
Dewbre, CarolBiomedical Sciences-Physiology1680 (970) 491-6187
Murphy, TerrieBiomedical Sciences-Physiology1680 (970) 491-8626
Martin, BrendaBiomedical Sciences-Physiology1680 (970) 491-7379
Mornes, DavidBiomedical Sciences-Physiology1680 (970) 492-4103
Castor, LindaBlack Student Services8016 (970) 491-1653
Gehrke, CarolBlack Student Services8016 (970) 491-2324
Gehrke, CarolBookstore8035 (970) 491-2324
Castor, LindaBookstore8035 (970) 491-1653
Bangert, LariCampus Recreation8027 (970) 491-7813
Smeltzer, MarshaCampus Recreation8027 (970) 491-2011
Gehrke, CarolCareer Center8008 (970) 491-2324
Castor, LindaCareer Center8008 (970) 491-1653
Thompson, AngelaCEMML1490 (970) 491-1521
Horvath, JessicaCEMML1490 (970) 491-1391
Suniga, GregoryClinical Sciences1678 (970) 491-8182
Davis, RobertaClinical Sciences1678 (970) 491-0511
Reid, JoyceClinical Sciences1678 (970) 297-4260
Berg, BarbaraColorado State Forest Service5060 (970) 491-7293
Olson, JillColorado State Forest Service5060 (970) 491-8435
Gutierrez, JustineConference Services8037 (970) 491-4736
Siefken, DianeConference Services8037 (970) 491-4751
Castor, LindaConflict Resolution and Student Conduct Services8015 (970) 491-1653
Gehrke, CarolConflict Resolution and Student Conduct Services8015 (970) 491-2324
Weskamp, KatherineCSU Police Department6023 (970) 491-1158
Hanawalt, ChristinaCSU Police Department6023 (970) 491-1159
Castor, LindaDining Services8030 (970) 491-1653
Gehrke, CarolDining Services8030 (970) 491-2324
Asmus, JulieEnvironmental and Radiological Health Sciences1681 (970) 491-5222
Wright, MerryEnvironmental and Radiological Health Sciences1681 (970) 491-0294
Remsik Larsen, JuliaEnvironmental and Radiological Health Sciences1681 (970) 297-4253
Wartenbe, AnidaEnvironmental Health Services6021 (970) 491-6745
Pena, DanielEnvironmental Health Services6021 (970) 491-4834
Adams, LoisFacilities Management6030 (970) 491-0054
Balliet, DonnaFacilities Management6030 (970) 491-0055
Dahleen, KimFacilities Management6030 (970) 491-0051
Monzingo, LisaFort Collins - Diag Lab1644 (970) 297-4163
Kammerzell, JamesFort Collins - Diag Lab1644 (970) 297-1298
Heighes, ConnieFort Collins - Diag Lab1644 (970) 297-5061
Gutierrez, JustineHDS Administration8045 (970) 491-4736
Siefken, DianeHDS Administration8045 (970) 491-4751
Gutierrez, JustineHDS Clearing Account8042 (970) 491-4736
Gutierrez, JustineHDS Operations Management8046 (970) 491-4736
Siefken, DianeHDS Operations Management8046 (970) 491-4751
Siefken, DianeHDS Technology Services8047 (970) 491-4751
Gutierrez, JustineHDS Technology Services8047 (970) 491-4736
Hines, KennethLaboratory Animal Resources2007 (970) 491-5227
Cary, StevenLaboratory Animal Resources2007 (970) 491-4680
Occhiuto, PamelaLaboratory Animal Resources2007 (970) 491-3532
Gehrke, CarolLory Student Center8033 (970) 491-2324
Castor, LindaLory Student Center8033 (970) 491-1653
Moller, LindaMicrobiology1677 (970) 491-0538
Anaya, LisaMicrobiology, Immunology and Pathology1682 (970) 491-3988
Fritzler, JeanetteMicrobiology, Immunology and Pathology1682 (970) 491-7388
Pundt, LindaMicrobiology, Immunology and Pathology1682 (970) 491-1630
Guillory, AndreaMicrobiology, Immunology and Pathology1682 (970) 491-6798
Siefken, DianePingree Park8044 (970) 491-4751
Gutierrez, JustinePingree Park8044 (970) 491-4736
Gutierrez, JustineRamCard Office8041 (970) 491-4736
Siefken, DianeRamCard Office8041 (970) 491-4751
Siefken, DianeResidence Life8032 (970) 491-4751
Gutierrez, JustineResidence Life8032 (970) 491-4736
Gutierrez, JustineResidential Dining8034 (970) 491-4736
Siefken, DianeResidential Dining8034 (970) 491-4751
Pena, DanielRisk Management and Insurance6002 (970) 491-4834
Alexander, SallyRisk Management and Insurance6002 (970) 491-7726
Wartenbe, AnidaRisk Management and Insurance6002 (970) 491-6745
Gehrke, CarolStudent Media8038 (970) 491-2324
Castor, LindaStudent Media8038 (970) 491-1653
Miller, KarinVeterinary Teaching Hospital1620 (970) 297-1268
Sexton, KathieVeterinary Teaching Hospital1620 (970) 297-1269