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Arizona Form Center


Welcome to the most extensive library of workers' compensation forms available anywhere. Almost 3,000 forms are available for your immediate download and use. Our forms, all of which have been custom programmed by WorkersCompensation.com for Type & Save functionality, are available for individual purchase below.

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(101) Employers Report of Injury (101) - 7/01
Form 104 - Notice of Claim Status - UNAVAILABLE ONLINE Multi page carbon form. This form can be obtained from The Industrial Commission of Arizona (602) 542-4653
Form 108 - Wage Calculation - UNAVAILABLE ONLINE Multi page carbon form. This form can be obtained from The Industrial Commission of Arizona (602) 542-4653
(wri) Worker's Report of Injury - 5/02
(rh) Request for Hearing - 5/02
(ica549) Waiver of Right of Rehearing and Appeals - N/D
(doc) Request to Change Doctors - 12/08
(leave) Request to Leave State - 8/07
(pr) Petition to Reopen Based on New, Additional or Previously Undiscovered Disability or Condition - 5/02
(fatality) Claim for Dependents Benefits - Fatality - 5/00
(prr) Petition for Rearrangement or Readjustment of Compensation - 5/02
(dat) Certification of Employers Drug and Alcohol Testing Policy - N/D
(pea) Professional Employer Agreement Notice - N/D
(haz) Notice of Alleged Health or Safety Hazards - N/D
(consult) Request for Consultation - N/D
(dis) Discrimination Form (English) - N/D
(dis-sp) Discrimination Form (Spanish) - N/D
(complaint-sp) Complaint Form (Spanish) - N/D
(badfaith) Complaint of Bad Faith and/or Unfair Claim Processing Practices - N/D
(sii) Application for Authorization to Self-Insure - Individual - N/D
(sip) Application for Authorization to Self-Insure - Pool - N/D
(lia) Workers Compensation Liability - N/D
(bond) Self-Insurance Workers Compensation Guaranty Bond Form - N/D
(parent) Parent Company Guaranty - N/D
(sio) Self-Insured Option - Pool - N/D
(spmed) Self Provider Medical Benefits - N/D
(term) Notice of Self Insurer Termination - N/D
(poster) Work Place Safety Poster (English and Spanish) - N/D
(workersCompLaw) Workers Compensation Law Poster (English and Spanish) - N/D
(ExposureReport) Report Of Significant Work Exposure To Bodily Fluids Or Other Infectious Material - 6/09