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.

CaliforniaNevadaArizonaUtahColoradoNew MexicoNebraskaKansasOklahomaTexasLouisianaArkansaMissouriIowaMinnesotaWisconsinIllinoisMississippiMichiganIndianaKentuckyTennesseeAlabamaGeorgiaFloridaNorth CarolinaSouth CarolinaVirginiaOhioPennsylvaniaNew YorkMarylandDelawareNew JerseyVermontNew HampshireMassachusettsConnecticutRhode IslandHawaiiAlaskaOregonWashingtonIdahoWyomingMontanaNorth DakotaSouth DakotaWest VirginiaMaineDistrict of Columbia
Lincoln Deferral Change FormN/A
Lincoln Enrollment and Beneficiary FormN/A
Claims AdministrationEnglishEspañol
Employee Accident Investigation Report
Employer Accident Investigation Report
CA State Claim Form (DWC-1)
Claims Reporting Procedures Packet
Consent for Release of Medical Information
Employee Refusal of Medical Treatment
Claims ProceduresEnglishEspañol
Claims Reporting Procedures Flowchart
Workers' Compensation Claim Protocols
Loss Control And SafetyEnglishEspañol
New Hire Safety Orientation Checklist
Post Accident Safety Sign Off Sheet
Progressive Discipline Program Form
Safety Meeting Sign Off Sheet
Safety Suggestion Form
Client Work Site Safety EvaluationN/A
Workers’ CompensationEnglishEspañol
Alabama PEO NoticeN/A
Payroll AdministrationEnglishEspañol
Direct Deposit Cancellation Form
Direct Deposit Reversal Affidavit Form
Lost Payroll Check Affidavit
Payroll Advance Deduction Authorization
Employee Data Change Form
Employee Separation Form
Generic FormsEnglishEspañol
New Hire Data Input Form
Direct Deposit
Workers’ CompensationEnglishEspañol
Certificate Request Form
New Class Code Location Request
Non-Temporary Staffing
Workers’ Compensation PosterEnglishEspañol
Light Industrial*

* Full-color printed posters are available upon request.