| Notice to Employees - Notice to Employees of Workers' Compensation Insurance for Industrial Injuries and Diseases Poster |
| Panel of Providers – Notice to All Employees - Includes instructions and a listing of designated Health Care Providers. |
| Workers' Compensation Claims Report
(Page 1) - Directions for completion of the Incident Investigation Report and the Work-Related Incident Report. |
| Incident Investigation Report (Page
2) - To be conducted by the supervisor with the employee. |
| Work-Related Incident Report (Page
3) - Employee and Incident Information, Medical Authorization & Treatment. (Employer's Copy) |
| Employee's Acknowledgement Under
Section 306 (F.1)(1)(I) - Recognition and agreement that employer has posted providers information and presented written notice setting forth rights and duties under Section 306 (F.1)(1)(I) |