• REFUSAL OF MEDICAL OBSERVATION

  • I have been involved in a work-related incident and have reported this to my supervisor who has advised me that I have the right to see the Company's medical provider for observation & treatment as needed. The potential medical risks / benefits have been explained to me by a PWJV first aid trained individual and I understand those risks. Due to the nature of the incident, I am declining medical observation at this time. PCL Construction Services Webcor A Joint Venture has recommended I seek medical attention and has in no way attempted to influence my decision.

  • Date*
     - -
  • Format: (000) 000-0000.
  •  
  • Should be Empty: