PHYSICIAN/HEALTH CARE

Use this tab to enter detailed information about the physician and/or health care facility, if required for this case record.

Update this tab whenever an employee has been injured in a work-related accident or reports an illness caused by working conditions.

Employee Treated in Emergency Room

Select this check box if the employee was treated for the injury/illness in the emergency room. This information is requested on the OSHA 301 Form.

Employee Hospitalized Overnight as an Inpatient

Select this check box if the employee was hospitalized overnight as an inpatient. This information is requested on the OSHA 301 Form.

Physician

Use the fields in this group box to record the name and address information for the attending physician.

Name

Enter the name of the attending physician in this optional field.

Address

Enter the street portion of the attending physician's address in this optional field.

City

Enter the city portion of the attending physician's address in this optional field.

State/Province

Enter, or use to select, the code for the state/province portion of the physician's address. State/province codes are validated against the system's State table. This is an optional field.

Postal Code

Enter the zip code or foreign postal code portion of the attending physician's address. This field is optional.

Hospital

Use group box to record name and address information for the facility treating the employee's injury or illness.

Name

In this optional field, enter the name of the treating facility.

Address

Enter the street portion of the facility's address in this optional field.

City

Enter the city portion of the facility's address in this optional field.

State/Province

Enter, or use to select, the code for the state/province portion of the treating facility's address. State/province codes are validated against the system's State table. This is an optional field.

Postal Code

Enter the zip code or foreign postal code portion of the facility's address in this optional field.