Risk Management Forms
These forms are meant to be downloaded to your computer and printed out using the free AdobeAcrobat software/web browser plug-in. If you do not already have a copy of Acrobat, you may download and install a copy by clicking on the link below:
http://www.adobe.com/prodindex/acrobat/readstep.html
Accident Investigation/Incident Report
Accounting Forms
Activity/Trip Forms
- Accident Insurance Application (attach completed Check Request form)
- Authorization To Use Privately Owned Vehicles on University business
- Check Request
- Construction, Remodeling, and Renovation
- Driver Authorization
- Driver's Questionnaire (fill out only once annually)
- Golf Cart Driver Agreement
- Medical Treatment Authorization
- International Insurance Form (please attach a copy of the approved Travel Authorization Application form)
- Waiver of Liability and Assumption of Risk Agreement (single use)
Event Planning: Risk Information Forms
Event Insurance Coverage
This document is for use by third parties requesting use of La Sierra University property for specific events. It protects both the facility user and the institution against claims by the third party who may be injured as a result of participating in an event.
Fire Incident Report
Fire Safety & Emergency Evacuation
- Emergency Notification System and Procedures
- Fire Safety & Emergency Evacuation Guide
- LSU Campus Fire Safety Annual Compliance Report
Fire Watch
Hazardous Materials Documents
Hazard Report
Injury and Illness Report
Inspection Forms
- Art VAC Inspection Report
- Biology PSC Inspection Report
- Chemistry PH Inspection Report
- Physical Plant Inspection Report
- Physics SFH Inspection Report
- Quarterly Building Inspection Report (Excel)
- Quarterly Building Inspection Report (PDF)
- Weekly Inspection Checklist Physical Plant
- Weekly Inspection Checklist Visual Arts Center
Insurance Forms
- Accident Insurance Application (attach completed check request form)
- International Insurance Form (please attach a copy of the approved Travel Authorization Application form
To file any of the following claims, please contact La Sierra University Risk Management at riskmanagement@lasierra.edu
ARM-Automobile Loss Notice
General Liability Loss Notice
Medical Payments Claim
Property Loss Notice
Miscellaneous Forms
Motorpool Documents
- Motor Vehicle Records Check - Driver's Questionnaire (fill out only once annually)
- Safety Service and Inspection
- Vehicle Use Authorization Request
Policy
Safety - Right to know
Safety Building Coordinators Information
Videotaping
Worker's Compensation
- Form 5020 (Employer's Report of Occupational Injury or Illness)
- Workers Compensation Claim DWC1
La Sierra On: