Student Accident, Injury or Illness Report Form accident

(click the link above to access and print the form)

In the event of an accident, injury or illness on campus, a student report must be submitted to the Student Health Center within 48 to 72 hours. The report should be filled out by the faculty or staff member who was advising the student during the time of the accident or injury before being turned into the Health Center. Once that report is submitted the student can begin to fill out paperwork for supplemental Student Accident Insurance at the Health Center. 

Accident Reporting and Insurance:

Cuesta College has LIMITED supplemental Student Accident Insurance for injuries sustained during school-related accidents and activities. If you have other medical insurance coverage, all benefits under that policy must be fully utilized before the Student Accident Insurance policy applies. The Student Accident Insurance company will determine the eligibility of all submitted claims. It is the student’s responsibility to report accidents to the Student Health Center within 72 hours.