State Board of Workers' Compensation Forms

FORM#

TITLE

 

Bill of Rights (Revised 7/2019)

 

 

Bill of Rights (Revised 7/2019) - Español

 

 

Panel of Physicians (Revised 7/2006)

 

 

Panel of Physicians (Revised 7/2006) - Español

 

 

Wage Statement (Revised 12/2018)

 

 

Notice of Election or Rejection of Workers' Compensation Coverage (Revised 5/2013)

 

 

Employer's First Report of Injury (Revised 12/2018)