Tools & Documents for Workers

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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
2023-07-26

Authorization for Release of Protected Health Information

Authorization for release of protected health information (HIPAA compliant)

Type
PDF
Last Updated
2023-07-26

Common Workers' Comp Terms

Type
PDF
Last Updated
2023-07-26

First Fill Program Pharmacy Card

Type
DOC
Last Updated
2023-07-26

Form AR-C Claim for Compensation

Type
PDF
Last Updated
2023-07-26

Form AR-N Employees Report of Injury

Type
PDF
Last Updated
2023-07-26

Mileage Claim Form

Type
PDF
Last Updated
2023-07-26