Accident/Injury Report Form
Step-by-step Instructions for Reporting Employee Injuries
If you are injured while on the job, you need to immediately do the following:
Hours: 7:00 a.m.-7:00 p.m.
Franciscan Working Well (Formerly St. Francis)
747 E. County Line Rd.
West of Emerson Ave.
This facility should be used for daytime needs.
Hours: 7:00 p.m.-11:00 p.m.
Greenwood Immediate Care
(Formerly Immediate Care Center)
1001 North Madison Ave.
Near Greenwood Mall
This facility is for night time use only.
NOTE: If an injury is Serious or Life Threatening, an ambulance should be called or transportation provided to the closest emergency room. However, less threatening incidents need to follow the above mentioned guidelines. Failure to do so can nullify our Worker’s Compensation coverage.