Client Center

Up-to-Date Resources and Forms

Client Resource Center

Client forms, including new hire enrollment packets, are available by clicking the appropriate state on the below map. Forward necessary forms to your Payroll Specialist upon completion.

Click a state to view applicable client forms

Benefits

English

Spanish

Lincoln Enrollment and Beneficiary Form

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Lincoln Deferral Change Form

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Claims Administration

English

Spanish

Employee Refusal of Medical Treatment

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Consent for Release of Medical Information

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Claims Reporting Procedures Packet

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CA State Claim Form (DWC-1)

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Employer Accident Investigation Report

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Employee Report of Injury

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Claims Procedures

English

Spanish

Workers’ Compensation Claim Protocols

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Claims Reporting Procedures Flowchart

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Loss Control And Safety

English

Spanish

Client Work Site Safety Evaluation

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Safety Suggestion Form

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Safety Meeting Sign Off Sheet

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Progressive Discipline Program Form

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Post Accident Safety Sign Off Sheet

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New Hire Safety Orientation Checklist

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Payroll Administration

English

Spanish

Employee Separation Form

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Employee Data Change Form

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Payroll Advance Deduction Authorization

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Lost Payroll Check Affidavit

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Direct Deposit Reversal Affidavit Form

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Direct Deposit Cancellation Form

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Generic Forms

English

Spanish

Direct Deposit

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Workers’ Compensation

English

Spanish

New Class Code Location Request

Non-Temporary Staffing

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Certificate Request Form

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Alabama PEO Notice

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Workers’ Compensation Poster

English

Spanish