This electronic form MUST be completed by a Manager immediately following notification of an Employee Injury/Incident, regardless of how small or insignificant the injury/incident.

• Call HR (Dianna Stepp, ext 0962 or Tricia Cutshall, ext 0269)
• Call HR to inform of the injury/incident. The timeframe of this call should be done based on the seriousness of the injury.
• Some clinics require the injured employee to bring a form with them. HR will provide you with that form, if it is required.

Drug Screen Required

The employee MUST complete a Drug Screen, within one hour of the injury/incident, regardless of whether or not they wish to seek medical treatment.
If the employee reports the incident more than one hour after the incident occurred, they must complete a Drug Screen within one hour of the report.

Workers’ Comp/Drug Screen Designated Facilities

Corinth:

• First Action for Corinth Employees: Manager/Supervisor Must Call the Triage Nurse – MedCor (800) 775-5866; Triage Nurse will Provide Instruction
• Treatment and/or Drug Screen: Physicians Urgent Care, 2601 Getwell Rd, Suite 1, Corinth

Florence:

• Treatment and/or Drug Screen: MedPlus-Florence, 2908 Mall Rd, Florence

Hoover:

• Treatment and/or Drug Screen: American Family Care (AFC Urgent Care), 1680 Montgomery Hwy, Vestavia Hills

Muscle Shoals:

• Treatment and/or Drug Screen: MedPlus-Muscle Shoals, 108 Avalon Ave, Muscle Shoals

Prattville:

• Treatment and/or Drug Screen: American Family Care (AFC Urgent Care), 1965 Cobbs Ford Rd, Prattville

Selma:

• Treatment and/or Drug Screen: Selma Urgent Care, 1025 Medical Center Pkwy, Selma

If the injury warrants an ambulance, call 911 first.