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: Working Fit – Helen Keller Hospital, 1300 S Montgomery Ave, Sheffield
Hoover:
- Treatment and/or Drug Screen: American Family Care (AFC Urgent Care), 1680 Montgomery Hwy, Vestavia Hills
Muscle Shoals:
- Treatment and/or Drug Screen: Working Fit – Helen Keller Hospital, 1300 S Montgomery Ave, Sheffield
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