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Workers' Compensation

Ergonomic Evaluation Request

Form icon

Click on the icon on the left to submit an ergonomic evaluation of your work space.  For questions, please contact Myrna Wright.

Claim Forms

All of these forms are found in red packets available to you at your school site. See the Office Manager

Click on the blue titles below to get the electronic version of these forms:

           (Complete this form for all incidents)

           (Complete this form for all injuries requiring medical attention)

           (Give to authorized doctor's office, 1st visit)

                 (Prescription authorization for work related injuries)

Instructions: Download form(s) above, complete and submit to Myrna Wight in the Human Resources Department.

Please contact Myrna Wight with any questions at Myrna_Wight@pvusd.net or (831) 786.2100, ext 2960