Weekly Indemnity Forms

(If necessary, right click on file and "Save Target As")

Weekly Indemnity Procedures (Please Read)
Weekly Indemnity Explanation of Procedures (Please Read)

Employee's Statement - Side 1  Side 2 - Print Both Sides

Doctor's Statement - General - Print For Dr.

You may Fax your form to the Lost Time Office
905-615-3356
(Scan to .doc or .pdf and Fax with http://www.gotfreefax.com/ or
http://www.myfax.com/free/)

Doctor's Statement - Pregnancy
Doctor's Statement - Phychiatric
Doctor's Statement - Musculo Skeletar / Motor Vehicle Accident

Other Forms

Sun Life Dental Form
Sun Life Medical Form

Fillable Incident Report (fill in & Print)

Over Time Slips
Incident Report
Route Evaluation Report