Skip to the content
Cal State L.A.

Menu

Worker's Compensation Forms

The forms that are listed below are available in Microsoft Excel format. The Application for Employment/Medical Staff Supplement is available as a download in PDF format only.
Get Acrobat Reader


Supervisor's Report of Occupational Injury or Illness

Employee's Report of Occupational Injury or Illness

Workers' Compensation Personal Physician Designation

 

 

 

 

 

5151 State University Drive . Los Angeles . CA 90032 . (323) 343-3000
© 2008 Trustees of the California State University

Last Update: 06/2/2009