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State University System of Florida: Board of Governors

When and How to Report

Report to Florida Atlantic University College of Medicine Self-Insurance Program care of the University of Florida J. Hillis Miller Self-Insurance Program


Immediately upon the occurrence of a potentially reportable event (as soon as the patient's needs are addressed), notify the Self-Insurance Program by calling the Gainesville, FL administrative offices:

    Contact Information for the Gainesville Administrative Offices
    Gainesville, FL

    UF Self-Insurance Program
    2124 NE Waldo Road, Suite 3100
    PO Box 112735
    Gainesville, FL 32611-2735
    Phone: 352-273-7006
    Fax: 352-273-7287

DO NOT USE E-MAIL TO MAKE REPORTS!!

During business hours, you will be connected to a SIP coordinator who will take the information and provide guidance. After normal business hours, leave a message as instructed by the voice mail and a coordinator will return your call.

Information we will need to know:

  • Name, sex, and age of patient
  • Medical record number
  • Date of admission and admission diagnosis
  • Date, time, and location (e.g. inpatient facility, outpatient clinic) of the occurrence
  • Brief description of the occurrence with the names of the involved individuals and witnesses
  • Description of the injury, the treatment provided, and the name(s) of the physician(s) notified

Residents must also notify their Attending and department residency program director. Students/Other Staff members must notify their supervisors.


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University of Florida J. Hillis Miller Self-Insurance Program
2124 NE Waldo Road, Suite 3100 | PO Box 112735 | Gainesville, FL 32611-2735
Phone: 352-273-7006 | Fax: 352-273-7287

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