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2016 Financial Highlights

Type
PDF
Last Updated
2016-09-08

2017 Press Kit

Type
PDF
Last Updated
2016-09-08

Acceptance of Officers Form (LA)

Type
PDF
Last Updated
2016-09-08

Acceptance of Officers Form (MS, AR, TX)

Type
PDF
Last Updated
2016-09-08

Application for Supplemental Income (English)

Application for Supplemental Income Benefits

Type
PDF
Last Updated
2016-09-08

Arkansas Claim Penalties

Type
PDF
Last Updated
2016-09-08

Arkansas Class Codes and Rates

Type
PDF
Last Updated
2016-09-08

Arkansas First Report of Injury Form

Type
PDF
Last Updated
2016-09-08

Authorization For Release of Medical Records

I hereby authorize the Arkansas Workers’ Compensation Commission to release my medical records in its possession.

Type
PDF
Last Updated
2016-09-08

Authorization for Release of Protected Health Information

Authorization for release of protected health information (HIPAA compliant)

Type
PDF
Last Updated
2016-09-08

Banks Supplemental Application

Type
PDF
Last Updated
2016-09-08

Showing 1 - 20 of 122 results