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State Board of Workers' Compensation Forms

FORM#

TITLE

 

Bill of Rights (Revised 7/2023)

 

 

Bill of Rights (Revised 7/2023) - Español

 

 

Panel of Physicians (Revised 07/2023)

 

 

Panel of Physicians (Revised 07/2023) - Español

 

 

Wage Statement (Revised 12/2018)

 

 

Notice of Election or Rejection of Workers' Compensation Coverage (Revised 07/2023)

 

 

Employer's First Report of Injury (Revised 07/2021)