State Board of Workers' Compensation Forms

FORM#

TITLE

 

Bill of Rights (Revised July 2016)

 

 

Bill of Rights (Revised July 2016) - español

 

 

Panel of Physicians (Revised 2006)

 

 

Panel of Physicians (Revised 2006) - español

 

 

Wage Statement (Revised 2017)

 

 

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

 

 

Employer's First Report of Injury (Revised 2017)