24/7 Injury Triage Information Form

Thank you for your interest in MEMIC’s 24/7 Injury Triage and Telehealth service. MEMIC policyholders may utilize the 24/7 Injury Triage service for any non-emergency work-related injury, at any time.

To get started, please fill out the form below. You will then have access to the Injury Triage Resource page where you can download the 24/7 Injury Triage Resource Kit for information about how Injury Triage and Telehealth works and how to access the service in the event of a work-related injury. It includes a handy check list, posters, and informational materials to share with your supervisors, managers, and injured employees.

Please note: upon clicking the "Submit" button below, you will be brought to the 24/7 Injury Triage Resource page where you can download the 24/7 Injury Triage Resource Kit.

Contact Information for Resource Kit
Policyholder Information