Free Forms to Help You
Worker’s Compensation Forms
- Affidavit for Time-Loss Compensation
- Application for L.E.P. Compensation
- Application to Reopen Claim
- AP Rating Request
- Appeal Cover Letter
- Authorization for Release of Information
- Change of Attending Physician Form
- Confirmation of Witnesses (Board of Appeals)
- Letter Enclosing Subpoena and Requesting CV
- Letter with Interrogatories and Request for Production
- Lost Warrant Form
- Protest and Request for Reconsideration
- Request for 20-Day Extension to Respond
- Request for DME Report Only
- Request for Specific Medical Records
- Request for Wage Verification
- Request IME Report
- Request Updated Copy of File
- Requests for Transcripts & Extension (Board of Appeals)
- Statement for Pharmacy Services
- Travel Reimbursement Request
- Work Status
Personal Injury Forms
- Activities of Daily Living Form
- Examination Questionnaire
- Injury Diary
- Medical Expenses Worksheet
- PI Documentation Checklist
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