Click on the links below to open a copy of the form or sample
document. If you have any problem printing the
forms, check our tips for
downloading and printing forms.
| Form
|
Format
|
| Bona Fide Offer of Employment Letter (Sample) |
DOC
|
PDF |
| Incident Analysis Form |
DOC |
PDF
|
| Medical Release of Information |
DOC
|
PDF
|
| Notice to employees concerning workers' compensation in Texas |
|
PDF
|
| Notice to employees concerning workers' compensation in Texas (Spanish) |
|
PDF
|
| Employee Notice of Ombudsman Services |
|
PDF
|
| Notice of Injured Employee Rights and Responsibilities in the Texas Workers' Compensation System |
|
PDF
|
| Notice of Injured Employee Rights and Responsibilities in the Texas Workers' Compensation System (Spanish) |
|
PDF
|
| DWC-1, Employer's First Report of Injury or Illness |
|
PDF
|
| DWC-2, Employer's Report for Reimbursement of Voluntary Payment |
|
PDF
|
| DWC-3, Employer's Wage Statement |
|
PDF
|
| DWC-3S, Employer's Wage Statement (Spanish) |
|
PDF
|
| DWC-3ME, Employee's Multiple Employment Wage Statement |
|
PDF
|
| DWC-3MES, Employee's Multiple Employment Wage Statement (Spanish) |
|
PDF
|
| DWC-3SD, Employer's Wage Statement for School Districts |
|
PDF
|
| DWC-3SDS, Employer's Wage Statement for School Districts (Spanish) |
|
PDF
|
| DWC-4, Employer's Contest of Compensability |
|
PDF
|
| DWC-6, Supplemental Report of Injury |
|
PDF
|
| DWC-73, Work Status Report |
|
PDF
|
| DWC-81, Agreement Between General Contractor and Subcontractor to Provide Workers’ Compensation Insurance |
|
PDF
|
| DWC-82, Agreement Between Motor Carrier and Owner Operator to Provide Workers’ Compensation Insurance Coverage / Agreement to Require Owner Operator to Act as Employer |
|
PDF
|
| DWC-83, Joint Agreement to Affirm Independent Relationship for Certain Building and Construction Workers / Agreement to Establish Employer-Employee Relationship for Certain Building and Construction Workers |
|
PDF
|
| DWC-83S, Joint Agreement to Affirm Independent Relationship for Certain Building and Construction Workers / Agreement to Establish Employer-Employee Relationship for Certain Building and Construction Workers (Spanish) |
|
PDF
|
| DWC-84, Exception to Application of Joint Agreement to Affirm Independent Relationship for Certain Building and Construction Workers |
|
PDF
|
| DWC-85, Agreement Between General Contractor and Subcontractor to Establish Independent Relationship |
|
PDF
|
For more forms related to workers’ compensation insurance or general workplace issues,
visit the appropriate agency’s website, listed below.
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