Guide to Worker's Compensation Process

Download Worker's Comp forms here. If you haver any questions about how to fill out or submit these forms, please phone Bob Shonak at x6064 or use the web form below to send your question, and Bob will get back to you.

Employer Information

• Employers Guide to Workers Comp

Employee Claim Process

• Injury Report Hard Copy Revised 052710
• Injury Report Electronic

Employer Process

• 127 Form
• 101 Form
• Letter to Department Heads
• City of Springfield Claim Kit

Medical Treatment Process

• After Hours Call Center Services
• Concentra Contact Information
• Concentra Authorization Form During Business Hours
• Concentra Treatment Process
• Emergency Department Instructions
• Map to Concentra Medical Center
• Release of Medical Information
• 2018 Referral Letter to Patients

Supervisor Report Forms

• Supervisor Accident Report Hard Copy
• Supervisor Accident Report