WORKPLACE INJURY

Medical emergency

  1. Call 911
  2. Notify supervisor. Fill out the Supervisor Report of Injury
  3. Fill out the Employee Injury Report
  4. Fill out the Witness Incident Report(s)
  5. Notify HR at ext. 1925/1903 of release conditions

Medical attention required

  1. Refer to occupational health clinic and give the Employer Authorization Form
  2. Notify supervisor. Fill out the Supervisor Report of Injury
  3. Fill out the Employee Injury Report
  4. Fill out the Witness Incident Report(s)
  5. Notify HR at ext. 1925/1903 of release conditions

No Medical attention required

  1. Fill out the Supervisor Report of Injury
  2. Fill out the Employee Injury Report
  3. Fill out the Witness Incident Report(s)
  4. Notify HR at ext. 1925/1903
 

Additional Documents:

EFFECTIVE APRIL 30, 2018, U.S. HEALTHWORKS CENTERS IN ARIZONA WILL BECOME CONCENTRA CENTERS

Concentra Employer Authorization Form (employees must have this completed and signed when going to a Concentra Medical Center)

Injury Reporting Checklist 

Concentra Locations

TOM Employee Exposure Form (chemical substance)

For incidents involving exposure to bodily fluids fill out the Significant Exposure to Bodily Fluids Form and contact HR for protocol.

To report hazards, unsafe conditions, near misses, concerns or suggestions please complete this Reporting Form.

 

TOWN VEHICLE/PROPERTY INVOLVED 

For injuries/incidents involving a Town vehicle or property, refer to the Claims Management Administrative Directive and follow the protocol. CDL drivers should also refer to Chapter 7 of the Town's Personnel Policies and Procedures Manual for additional accident-related protocols.