Workers Compensation Form

Click here to report injury online

Steps to Handle a Work-Related Injury

Step 01

Notify your supervisor immediately, you will ALSO need to report your injury within 24 hours to ASBA at 1.855.769.7900

7:30 am-4:30 pm or 24/7 at www.arsba.org/home/weforml/

** If you have a life-threatening emergency, please call 911 or go to the nearest hospital Emergency Room **

Step 02

Notify Human Resources, Lindsay.davis@archford.org. You will be required to fill out a Form N. Only once this is done your report considered complete

Step 03

For injuries requiring medical attention, the Co-op will exercise its right to designate the initial treating physcian.

Step 04

Your initial appointment will be scheduled by Human Resources or ASBA staff

Please refer to your handbook for complete Workers Compensation procedures and protocols.