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(CO13) Injury Report Form

  1. Campbell County Public Safety Document Header
  2. Injury Report Form
  3. Name of Person Injured
  4. Hartford Form Attached?
  5. Electronic Signature Agreement

    By checking the "I agree" box below, you agree and acknowledge that: 

    • 1) your submission will not be signed in the sense of a traditional paper document;
    • 2) by signing in this alternate manner, you authorize your electronic signature to be valid and binding upon you to the same force and effect as a handwritten signature; and 
    • 3) you may still be required to provide a traditional signature at a later date.
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