Form	Instructions	Campus
UC Davis Workers' Compensation	For the Davis campus: The link at the left leads to Safety Services, where you will find Workers' Compensation forms, information and assistance.	UC Davis
Workers' Compensation Claim Form (DWC 1) & Notice of Potential Eligibility	For the Health campus: Complete this form to file a workers’ compensation claim with your employer. Submit to: Workers' Compensation, Fax: 916-734-2484	UC Davis Health
Workers' Compensation Departmental Injury/Illness Worksheet	For the Health campus: Complete this form to file a workers’ compensation claim with your employer. Submit to: Workers' Compensation, Fax: 916-734-2484	UC Davis Health