Online client forms

Every form we use, fillable here. Each one starts with your name, phone and email, then the questions for that form. You get a copy of everything you submit.

Case file, pen and reading glasses on a desk

For adjusters, TPAs, employers and defense counselNew Client FormRefer a Nevada workers' compensation file to us. Claimant, injury, employer, physician and the services you need.Fill it in → 8 steps

A blank page, pen and reading glasses on a desk

For injured workersInitial Vocational Evaluation QuestionnaireThe intake questionnaire your counselor works from. Work history, education, physical capabilities and what you would like to do next.Fill it in → 10 steps

For injured workers · English and SpanishConsent for Vocational Case ManagementConsent to Vocational Rehab Services coordinating the vocational side of your claim.Fill it in → 2 steps

For injured workersAuthorization to Release Medical InformationAuthorizes your providers to release records to Vocational Rehab Services. Valid one year, revocable in writing.Fill it in → 2 steps

Download and print

The one form that has to be on paper

I-9 Employment Eligibility VerificationFederal form — must be the official current version, so download, print and sign it. Confirm the revision at uscis.gov/i-9.PDF

Prefer paper for all of them? The whole packet is on the intake packet page. If you need help filling anything in, call or text 702-857-9460 — our staff can assist in English or Spanish.

Not sure which form you need?

Call or text 702-857-9460 and we will tell you.

New Client Form Call 702-857-9460