C-1 -- Notice of Injury or Occupational Disease
CCF-99 -- Supervisor's Accident/Injury/Incident Investigation Report
C-4 -- Employee’s Claim for Compensation
C-4A - Release of Medical and Other Information
Current Form Distribution:
Original kept at work site and a copy given to the employee. Email or fax a copy to Worker's Compensation at 702-799-2995 or workcomp@nv.ccsd.net.
D-1 -- Informational Poster
D-2 -- Brief Description of Your Rights and Benefits
D-12a -- Request for Hearing
D-26 -- Application for Reimbursement of Claim Related Travel Expenses
Provider Map (Rev. 06/20)
Provider Panel List (Rev. 10/20)
Pharmacy Benefits Poster
