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  1. Home
  2. Government
  3. Human Resources
  4. Report an Injury at Work

Report an Injury at Work

Injury Forms - Non-Public Safety

Instructions for reporting work-related injuries

  • Form 118
  • Form 101
  • Medical Authorization Form

Injury Forms - Public Safety

Instructions for reporting work-related injuries

  • Accident Report-Fire
  • Accident Report-Police
  • Medical Authorization form - Fire/Police

Injury Forms - School

Instructions/Protocol for reporting work-related injuries

  • Form 118
  • Form 101

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Contact Us

Haverhill City Hall
4 Summer Street
Haverhill MA, 01830

Monday - Friday 8:00 - 4:00
Call Center 311 (within city limits)
(978) 358-1311 (outside the city)

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