• Skip to main content
  • Skip to main navigation
UC Santa Cruz
  • MyUCSC
  • People
  • Calendars
  • Maps
  • A-Z Index

Risk Services

  • About
    • About Risk Services
    • Programs
    • Staff Directory
    • Organization Chart
    • Directions
    • Emergency Action Plan
  • Insurance
    • About Insurance & GET INSURANCE
    • UC Certificate of Self-Insurance Coverage FY 2021-22
    • About Supplier Insurance Requirements
    • Supplier Insurance Requirements
  • Claims
    • About Claims
    • Reporting
    • Deductibles
    • Property
  • Workers' Compensation
    • Workers' Compensation
    • Covid 19 Support
    • At-Home Covid-19 Test Kit
    • Injury Reporting & Medical Treatment
    • Designated Medical Treatment Providers
    • Workers' Comp Forms
    • WorkStrong Program
    • Be Smart About Safety
    • Transitional Return to Work
    • Occupational Wellness Programs
    • Telemedicine
    • Volunteers
    • Contact Us
  • Wellness
  • Quick Links
    • UC Certificate of Self-Insurance Coverage
    • Forms
    • Mexico & UC Vehicles
    • Minors
    • Risk Assessment
    • Volunteers
    • Waivers
    • Report a Claim
    • Report an Injury - Workers' Compensation
    • More Quick Links

Home / Workers Comp / ● Workers' Comp Forms

Workers' Compensation Forms

Workers' Comp Forms List

Workers' Compensation Forms, for assistance please contact the Workers’ Compensation office in Risk Services at

(831) 459-1787

or

(831) 459-2850

  • Employer's First Report of Injury (EFR)
    • Click on "Login" and then log in with your CruzID and Gold Password to access the online form. Click on "Create Claim."
  • Employee Authorization for Medical Treatment of Occupational Incidents
  • Volunteer Waiver and Election of Workers' Compensation
  • Pharmacy Benefit - Workers' Compensation Prescription Program
  • Beneficios Farmaceuticos - Workers' Compensation Prescription Program- Spanish
  • Workers' Compensation ESL Election Form & Instructions
  • Formulario Para Eleccion De La Compensacion De Los Trajadores -Workers' Compensation ESL Election- Spanish
  • Facts About Workers' Compensation pamphlet and Predesignation of Personal Physician Form
  • Informacion Acerca de la Compensacion de Trabajadores -Facts About Workers' Comp pamphlet-Spanish
  • Workers' Compensation
  • Covid 19 Support
  • ● At-Home COVID-19 Test Kit
  • Injury Reporting & Medical Treatment
  • ● Designated Medical Treatment Providers
  • ● Workers' Comp Forms
  • ● WorkStrong Program
  • ● Be Smart About Safety
  • Transitional Return to Work
  • Occupational Wellness Programs
  • ● Telemedicine
  • Volunteers
  • Contact Us
University of California
UC Santa Cruz, 1156 High Street, Santa Cruz, Ca 95064
©2022 Regents of the University of California. All Rights Reserved.
Office of the President Risk Services Staff Directory Feedback
  • Accreditation
  • Non-Discrimination Policy
  • Land Acknowledgement
  • Employment
  • Privacy Policy & Terms of Use
  • Sexual Violence Prevention & Response (Title IX)

Last modified: May 31, 2022 128.114.113.82