Forms

Occupational Forms:

Here are some forms to help you with your claims.

English:

• Western Employee Injury Report
• Eastern Employee Injury Report

Non-Occupational Forms:

Here are some forms to help you with your claims.

English:

• Early Intervention Contact
• DMI ROI Authorization
• Release of Information Authorization FIPPA

French:

• Intervention immédiate – Coordonnées (absent pendant 5 jours consécutifs)
• Autorisation de divulguer des renseignements