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Office Of Legal Affairs, Ethics, and Compliance

Columbus State University Incident Report and Claim Form

The purpose for this form is for general liability complaints due to injuries to a person or their personal property. If you are an employee and are injured while performing your duties for the University, please DO NOT use this form; and continue to file your workers compensation claim with Human Resources.

Notice to Claimant: In order to expedite the claims process, please have any and all documentation prior to filling out this form (pictures, police report, incident report from other areas on campus, doctors bills, repair estimates, etc.). If you do not have access to one or more of these documents, or receive them after filing the claim, please email them to so that they may be added.