Texas Forms
Injury Reporting Protocol (Texas)
Injury Reporting Protocol (Other States)
Workwell TX Employee Acknowledgement Form
Supervisor Accident Analysis Report
Worker’s Comp Certificate of Insurance Request (Contact Risk Management for this form)
Worker’s Comp Experience Modifier Rate (EMR) (Contact Risk Management for this form)
Workwell TX Network Information
Spanish Forms
SPANISH – Employee’s Notice of Injury
SPANISH – Workwell TX Network Information
Outside of Texas Injury Forms
Please contact Risk Management for that state’s specific form