Employee Forms
This is a collection of forms for employees.
Workers Compensation Forms
All incident and injury forms should be submitted within 24-hours of an incident or within 8-hours if the employee is hospitalized. Forms can be emailed to
If you have questions or need assistance with the forms, please call the Claims Manager at (907) 714-2353 or the Safety Manager at (907) 714-2354.
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Alius Health WC First Fill Form
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Employee Report of Occupational Injury or Illness
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Incident Statement Form
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KPBSD Compensation Options Letter
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Incident Statement Form
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Physicians Return to Work Checklist - Emergency Responders
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Physicians Return to Work Checklist - Occupational Injuries
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Incident Statement Form
