Workers Compensation

Claim Forms

(all these forms are found in red packets)

Click on the blue titles below to get the forms

           (Complete this form for all incidents)

           (Complete this form for all injuries requiring medical attention)

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

            (List of authorized doctors for work related injuries)

                 (Prescription authorization for work related injuries)


Contact Information

Phone: (831) 786-2100 Ext. 2960

Direct Line: (831) 786-2311

*NEW as of 5/10 Fax: (831) 761-6018

*Now in Human Resources Office*

Contact Myrna Wight -  Workers' Compensation Corrdinator