New Hire Enrollment Packets
New Hire Enrollment Packets may be accessed by selecting the applicable state. Please forward completed packets to your Payroll Tech upon hiring.
Claims Administration | English | Spanish | |||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|
Employee Accident Investigation Report |
|||||||||||||
Employer Accident Investigation Report |
|||||||||||||
Employee Report of Injury |
|||||||||||||
Employee Report of Injury |
|||||||||||||
CA State Claim Form (DWC-1) |
|||||||||||||
Claims Reporting Procedures Packet |
|||||||||||||
Consent for Release of Medical Information |
|||||||||||||
Employee Refusal of Medical Treatment |
* Full-color printed posters are available upon request.