Workers' Compensation

• Employer's Report of Occupational Injury or Illness
   
• Medical Mileage Expense Form
   
• Predesignation of Personal Physician Form
  English | Spanish
   
• Supervisor's Incident Investigation Report Form
   
• Workers' Compensation Claim Form (DWC1) & Notice of Potential Eligibility (version 01-01-16)
   
• Accommodation Equipment Form
   
• Interactive Conference Summary Form

Workers' Compensation Medical Facilities