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● Workers' Compensation Forms

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
Workers' Compensation ESL Election Form
Workers' Compensation ESL Election Instructions
Facts About Workers' Compensation pamphlet