Forms

Supervisor Instructions/Procedures

  1. WC Supervisor Instructions July 2023

First Report of Injury

  1. First Report of Injury (PDF)

Employee's Choice of Physician (Panel of Physicians)

  1. Panel of Physicians as of 7-19-22 fillable

Employee Contact Info Form

  1. Employee Contact Information form

Employee Instructions/Procedures

  1. Employee WC responsibilities 2023

Blood Exposure Packet

  1. Blood OPIM Exposure Packet 2023

Mileage Reimbursement Request Form

  1. Mileage Reimbursement request