Forms
Employees
Complete this form and provide it to your supervisor.
Supervisors
Complete this form, turn both the Employee Report of Injury and Supervisor’s report to Human Resources at hr@kern.org. If the employee is unsure of whether or not to seek care, please have the employee call 1-855-812-2778 to speak with a nurse.
Supervisor’s Report of Work Related Injury or Illness
BBP Post Exposure Evaluation
The top portion of this form is completed by the supervisor in the event of an Exposure Incident. The form is then sent to Human Resources who will complete the remaining follow-up procedures.