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Employer Toolkit - Alabama

Your resource for State Specific Forms and Regulatory Links

Visit our Employer FAQ page for answers to employer related questions.

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State Forms

  • AL - Notice to Exclude or Include Coverage for Himself, Officers or Members

  • AL Application for Certification of Drug-Free Workplace Premium Credit

  • AL Application for Re-Certification of Drug-Free Workplace Premium Credit

  • AL Fraud Poster

  • AL Notice of Election to Accept or Reject an Insurance Deductible

Claim Forms

  • AL Application for Certification of Drug-Free Workplace Premium Credit

  • AL Application for Re-Certification of Drug-Free Workplace Premium Credit

  • AL Fraud Poster

  • First Report of Injury [WCC Form 2]

  • Initial Treatment Authorization

  • New Policyholder Welcome Packet - AL

  • No Injury Certificate

  • No Treatment Requested Letter

  • Pharmacy Authorization - AL

  • Wage Statement

  • Wage Statement Letter

  • Workers’ Compensation Compliance Poster - SC

Links

Dept of Industrial Relations and Workers Comp

FFVA Mutual Insurance Co.
PO Box 948239
Maitland, FL 32794

321-214-5300
800-346-4825
Fax: 321-214-0220

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