Please note: most of these forms are for reference only, and you must contact the Health and Safety Department for an actual copy.
ADA Forms
Form A - Employee Disability Accommodation Request
ADA Form B - Physician's Certificate
ADA Form C - Employee Disability Accommodation Response (Supervisors)
ADA Form D - Accommodation Results
DMV Forms
Cart Safety Rules
Driver Data Form
Ergonomics Forms
GCCCD Ergonomics Procedures
Ergonomic Self Evaluation Form
Ergonomic Assessment Request
Ergonomic Equipment Guidelines
Ergonomic Equipment Selection List
Property and Casualty Forms
Claim Against GCCCD Form
Safety Forms
Record of Employee Safety Training
Workers' Compensation Forms
District Injury/Illness report
Employee Claim form, California DWC
Guidelines, California DWC
Instructions for Filing a Claim - Quick Reference
Map to Concentra Facilities
Map to KPOJ Facilities
Predesignation Form (DWC Form 9783)
Worker Comp Benefits
First Fill Prescription Card
Declination of Treatment (If Declining Medical Treatment)