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Authorization for Medical Treatment form

Locations for Medical Assistance

Employees with serious injuries or illnesses should call 911 for transport to the nearest emergency care facility. Employees with work related injuries (or illnesses) that are not serious or life threatening are to immediately contact their supervisor and advise them of their injury. If the injury requires medical treatment, the supervisor is to inform the employee of the University Preferred Provider for work related injuries and arrange for the employee to have the injury evaluated.

Currently the University has an arrangement with OSF HealthCare to provide evaluation and treatment for work related injuries at the OSF Occupational Health Center, the OSF Prompt Care locations and the OSF St. Joseph Medical Center Emergency Room. Employees are encouraged to seek treatment through OSF when injuries are of a nature that requires medical care.  Please follow the link to the OSF HealthCare locations for the Bloomington Normal area.

The injured employee must bring with them the Authorization for Medical Treatment form completed and signed by their supervisor or other appointed individual. This form includes directions on how to get to the OSF facilities.

2017-05-03T14:33:57.798-05:00 2017