Workers Compensation - Workmans Comp Service Center

Popular Features

WorkCompResearch
CompBob! Joke of the Week
CompTalk! Radio
CompTalk! Video
Send A Get Well Card
Post Job/Resume
Recommend This Site

Get Our E- Newsletter

Fresh News, Hot Topics, CompTalk! Radio and Video and More.

Florida 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.

Try a Forms Membership! If you have an ongoing need for multiple forms, and want complete and unrestricted access to our entire 3,000 "Type & Save" Forms Library, you may register for immediate access here. Annual subscribers to this service get the benefit of our forms updating system, making sure the forms they use are the most current available.

= Indicates this Type & Save form is available for individual purchase.

= FlashFormSSL Enabled.
Click here to learn more about auto-populating forms with FlashForm SSL.

		(dwc1) First Report of Injury or Illness - 3/09
		(dwc1a) Wage Statement - 3/09
		(dwc3) Request for Wage Loss/Temporary Partial Benefits - 3/09
		(dwc4) Notice of Action/Change - 3/09
		Instructions for Completion of the Health Insurance Claim Form / HCFA-1500 (12-90) not available for download - 5/05
		Instructions for Completion of the LES Form DWC-9 When submitted by Licensed Health Care Providers - 5/05
		Instructions for Completion of the LES Form DWC-9 When submitted by Work Hardening and Pain Management Programs - 5/05
		(dwc10) Statement Of Charges for Drugs And Medical Supplies - 3/07
		Instructions for Dental Claim Form (J512) - 3/07
		(dwc12) Notice of Denial - 3/09
		(dwc13) Claim Cost Report - 3/09
		(dwc14) Request for Social Security Disability Benefit Information - 3/09
		(dwc19) Employee Earnings Report - 3/09
		(dwc21) Department Reemployment Services Billing Form - N/D
		(dwc22) Reemployment Status Review - 5/04
		(dwc23) Request for Screening - 5/04
		(dwc25) Florida Workers' Compensation Uniform Medical Treatment/Status Report Form - 1/08
		Instructions for completion of the the DWC-25 - 1/08
		(dwc30) Authorization and Request for Unemployment - 3/09
		(dwc33) Permanent Total Off-Set Worksheet - 3/09
		(dwc35) Permanent Total Supplemental Worksheet - 3/09
		(dwc40) Statement of Quarterly Earnings for Supplemental Income Benefits - 3/09
		(dwc49) Aggregate Claims Administration Change Report - 3/09
		(dwc60) Important Workers' Compensation Information for Florida Workers - 8/04
		(dwc61) Informacion Importante De Seguro De Indemnizacion Por Accidentes De Trabajo Para Los Trabajadores De La Florida - 8/04
		(dwc65) Important Workers Compensation Information for Florida Employers - 8/04
		(dwc66) Informacion Importante Del Seguro De Indemnizacion Por Accidentes De Trabajo Para Los Empleadores De La Florida - 8/04
		(dwc250) Notice of Election to be Exempt - 12/08
		Instructions for completing Notice of Election to be Exempt - 12/08
		(dwc250r) Revocation of Election to be Exempt - 12/08
		(dwc251) Notice Of Election Of Coverage - 12/08
		(dwc251r) Revocation of Election Coverage - 12/08
		(EDI-1) Edi Trading Partner Profile - 10/06
		(EDI-2) Edi Trading Partner Insurer/Claim Administrator Id List - 10/06
		(EDI-3) Edi Transmission Profile - - Sender's Specifications - 10/06
		Instructions for POC EDI and Claims EDI - 10/06
		(EAO-1) Request for Assistance - 6/94
		(jcc.PFB) Petition for Benefits (Division of Administrative Hearings) - 1/08
		(jccResponsetoPFB) Response to Petition for Benefit - N/D
		(jccRACN) Request For Assignment Of Case Number - 1/08
		(mileage2) Mileage Reimbursement Form - N/D
		(ncci-9) Application for Drug-Free Workplace Premium Credit Program - 5/96
		(PW-2) Preferred Worker Reimbursement Request - 1/08
		(SDF-1) Proof of Claim - 1/08
		(SDF-2) Reimbursement Request - 1/08
		(SDF-6) Explanation of Benefits - 1/08
		(si-1) Application for Self-Insurance - 9/96
		(si-1a) Re-Application for Self-Insurance - N/D
		(si-4) Surety Bond - 9/96
		(si-4b) Self-Insurers Surety Bond - 9/96
		(si-5) Self-Insurers Payroll Report - 9/96
		(si-6) Sample Self-Insurers Irrevocable Letter of Credit - 9/96
		(si-11) Indemnity Agreement - 9/96
		(si-17) Self-Insurance Unit Statistical Report - 1/08
		(si-17na) Self-Insurance Unit Statistical Report (New Applicant) / Certification of Servicing for Self-Insurers - 9/96
		(si-20) Report of Outstanding Workers' Compensation Liabilities - 9/96
		(si-22) Service Company Application - 9/96
		(si-23) Service Company Annual Report Form - N/D
		(si-26) Actuarial Report Checklist - 9/96
		(si-27) Biographical Statement and Affidavit - 1/08
		(si-32) Assignment of Securities - Sample - 9/96
		(si-206) Certificate of Self Insurance - 9/96
		(ucc-1) Uniform Commercial Code Financing Statement - 1993
		(09-1) Application For Drug-Free Workplace Premium Credit Program - N/D
		(DupExeReq) Request For Duplicate Exemption - 1/08
		(UPPSampleFormC) Addendum To Stipulation In Support Of Petition For Order Approving A Lump-Sum Settlement - N/D
		(UPPSampleFormD) Child Support Enforcement - N/D
		(UPPSampleFormE) Affidavit In Support Of Attorney's Fees In Excess Of Statutory Guideline - N/D
		(UPPSampleFormF) Motion For Approval Of Attorney's Fee And Allocation Of Child Support Arrearage For Settlements Under Sections 440.20(11)(C), (D), And (E), Florida Statutes - N/D
		(VerifiedMotionSubstituteID) Verified Motion For Assignment Of Substitute Identification Number - N/D
		(Anti-FraudNotice) Anti-Fraud Poster - N/D

Member Login

Florida Form Center