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Volunteer Forms
- Claimant Information Packet: Information for people who will be making a claim
- Volunteer Ambulance Worker Accident Report (VAW-3): Volunteer use this form to report an injury to your Ambulance Squad
- Volunteer Firefighter Accident Report (VF-3): Volunteer use this form to report an injury to your Fire Department
- Limited Release of Health Information (C-3.3): Employees complete this form and turn in with the accident report form
- Medical Authorization: Employees complete this form and turn in with the accident report form
- Encounter Form Employees take this form with you to your medical provider.
- Pharmacy Benefits: Employees use these forms to obtain Pharmacy items related to your injury.
- Encounter Form: Employees take this form with you to your medical provider.
- Employers Report of Injury (C-2F) - Volunteer Fire Department Chiefs and Volunteer Ambulance Squad Captains use this form to report volunteer injuries to the Self Insurance Department.
