https://www.csn.edu/__data/assets/pdf_file/0027/163827/RMS-WorkerCompe…
UNIY. N EVADA S TATE. Q I,. l- J.i Ii. •CSN. , 'fiii:! CO I EGF Of. ,.-- SOUTI--IERNNEVACV. Worker’s Compensation Witness Form. • Name of injured employee:. • Your name (witness):. • Your phone and email:. • Location where incident