Colorado Department of Labor and Employment Forms
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Form WC6 "Entry of Appearance" - Colorado
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11 votes
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124 KB
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Form WC2 "General Admission of Liability" - Colorado
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29 votes
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427 KB
4 pages
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Form UITL-5 "Request for Seasonal Status" - Colorado
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24 votes
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30 KB
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Form UITL-2 "Employer Change Request" - Colorado
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25 votes
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354 KB
2 pages
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Form WC1 "First Report of Injury" - Colorado
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(4.3 / 5)
32 votes
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1 MB
5 pages
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Form WC35 "Application for Indigent Determination (Dime)" - Colorado
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33 votes
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1 MB
4 pages
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Form WC73 "Settlement Order" - Colorado
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35 votes
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1 MB
2 pages
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Form WC77 "Notice and Proposal and Application for a Division Independent Medical Examination (Dime)" - Colorado
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16 votes
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2 MB
4 pages
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Form WC76 "Request for Appointment to the Division Independent Medical Examination Panel (Dime)" - Colorado
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12 votes
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1 MB
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Form WC74 "Notice of Contest" - Colorado
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81 votes
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102 KB
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Form WC95 "Request for Insurer Information" - Colorado
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17 votes
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188 KB
3 pages
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Form UITL-18 "Power of Attorney" - Colorado
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16 votes
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152 KB
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Form WC62 "Request for Lump Sum Payment" - Colorado
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75 votes
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112 KB
3 pages
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Form UITL-78 "Request for Approval of Work-Share Plan" - Colorado
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18 votes
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26 KB
3 pages
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Form UITL-39 "Employee-Leasing Company Application, Annual Report, and Certification" - Colorado
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23 votes
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50 KB
4 pages
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Form WC44 "Exclusion of Uncompensated Public Officials" - Colorado
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(4.4 / 5)
20 votes
Size:
195 KB
3 pages
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Form UITR-6a "Multiple Quarter Adjustment of Workers' Wages" - Colorado
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53 votes
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36 KB
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Form UITR-6C "Social Security Number Corrections" - Colorado
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13 votes
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62 KB
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Form WC34 "Request to Erase (Redact) Medical Information From an Audio Recording" - Colorado
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22 votes
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503 KB
3 pages
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Form WC30 "Designated Health Care Provider Disclosure Form" - Colorado
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27 votes
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1 MB
4 pages
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Form WC15 "Workers' Claim for Compensation" - Colorado
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12 votes
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19 MB
4 pages
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Form WC18 "Dependent's Notice and Claim for Compensation" - Colorado
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22 votes
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17 MB
6 pages
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Form WC37 "Petition to Reopen" - Colorado
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(4.3 / 5)
13 votes
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3 MB
5 pages
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Form WC63 "Request for Offset of Liability to Subsequent Injury Fund" - Colorado
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23 votes
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148 KB
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Form WC70 "Application for Admission to the Colorado Major Medical Insurance Fund" - Colorado
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77 votes
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174 KB
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Form WC168 "Notice of Change of Carrier or Adjusting Firm" - Colorado
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18 votes
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174 KB
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Form WC192 "Motion to Close Claim for Failure to Prosecute" - Colorado
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21 votes
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1 MB
5 pages
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Form B-491 "Overpayment Waiver Request" - Colorado
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(4.5 / 5)
30 votes
Size:
112 KB
2 pages
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Form WC179 "Division Independent Medical Examination (Dime) Physician Summary Disclosure Form (Insurer or Self-insured Employer)" - Colorado
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22 votes
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2 MB
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Form WC165 "Notice of Dime Negotiations" - Colorado
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9 votes
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286 KB
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Form WC193 "Request for Disfigurement Award (Photo)" - Colorado
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22 votes
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68 KB
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Form WC189 "Authorization for Release of Information" - Colorado
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44 votes
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300 KB
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Form WC190 "Authorization for Release of Limited Information to Third Parties" - Colorado
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28 votes
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483 KB
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Form WC188 "Authorized Treating Provider's Request for Prior Authorization" - Colorado
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17 votes
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231 KB
4 pages
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Form WC195 "Notification by an Authorized Treating Provider" - Colorado
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9 votes
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184 KB
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Form WC153 "Fatal Case - Final Admission" - Colorado
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29 votes
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161 KB
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Form WC174 "Worker's Claim for Compensation Transmittal" - Colorado
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28 votes
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18 KB
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Form WC196 "Rehabilitation Communication Form" - Colorado
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25 votes
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Form WC134 "Request for Services" - Colorado
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25 votes
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70 KB
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![Form WC6 "Entry of Appearance" - Colorado](https://data.templateroller.com/pdf_docs_html/1796/17964/1796488/form-wc6-entry-of-appearance-colorado.png "Form WC6 "Entry of Appearance" - Colorado")
![Form WC2 "General Admission of Liability" - Colorado](https://data.templateroller.com/pdf_docs_html/1763/17639/1763943/form-wc2-general-admission-of-liability-colorado.png "Form WC2 "General Admission of Liability" - Colorado")
![Form UITL-5 "Request for Seasonal Status" - Colorado](https://data.templateroller.com/pdf_docs_html/2016/20164/2016451/form-uitl-5-request-for-seasonal-status-colorado.png "Form UITL-5 "Request for Seasonal Status" - Colorado")
![Form UITL-2 "Employer Change Request" - Colorado](https://data.templateroller.com/pdf_docs_html/1728/17283/1728371/form-uitl-2-employer-change-request-colorado.png "Form UITL-2 "Employer Change Request" - Colorado")
![Form WC1 "First Report of Injury" - Colorado](https://data.templateroller.com/pdf_docs_html/1763/17639/1763941/form-wc1-first-report-of-injury-colorado.png "Form WC1 "First Report of Injury" - Colorado")
![Form WC35 "Application for Indigent Determination (Dime)" - Colorado](https://data.templateroller.com/pdf_docs_html/2078/20780/2078084/form-wc35-application-for-indigent-determination-dime-colorado.png "Form WC35 "Application for Indigent Determination (Dime)" - Colorado")
![Form WC73 "Settlement Order" - Colorado](https://data.templateroller.com/pdf_docs_html/2078/20783/2078320/form-wc73-settlement-order-colorado.png "Form WC73 "Settlement Order" - Colorado")
![Form WC77 "Notice and Proposal and Application for a Division Independent Medical Examination (Dime)" - Colorado](https://data.templateroller.com/pdf_docs_html/2078/20783/2078322/form-wc77-notice-and-proposal-and-application-for-a-division-independent-medical-examination-dime-colorado.png "Form WC77 "Notice and Proposal and Application for a Division Independent Medical Examination (Dime)" - Colorado")
![Form WC76 "Request for Appointment to the Division Independent Medical Examination Panel (Dime)" - Colorado](https://data.templateroller.com/pdf_docs_html/2078/20783/2078321/form-wc76-request-for-appointment-to-the-division-independent-medical-examination-panel-dime-colorado.png "Form WC76 "Request for Appointment to the Division Independent Medical Examination Panel (Dime)" - Colorado")
![Form WC74 "Notice of Contest" - Colorado](https://data.templateroller.com/pdf_docs_html/1817/18174/1817419/form-wc-74-notice-contest-colorado.png "Form WC74 "Notice of Contest" - Colorado")
![Form WC95 "Request for Insurer Information" - Colorado](https://data.templateroller.com/pdf_docs_html/1788/17886/1788658/form-wc-95-request-insurer-information-colorado.png "Form WC95 "Request for Insurer Information" - Colorado")
![Form UITL-18 "Power of Attorney" - Colorado](https://data.templateroller.com/pdf_docs_html/1764/17642/1764207/form-uitl-18-power-of-attorney-colorado.png "Form UITL-18 "Power of Attorney" - Colorado")
![Form WC62 "Request for Lump Sum Payment" - Colorado](https://data.templateroller.com/pdf_docs_html/1796/17965/1796510/form-wc62-request-for-lump-sum-payment-colorado.png "Form WC62 "Request for Lump Sum Payment" - Colorado")
![Form UITL-78 "Request for Approval of Work-Share Plan" - Colorado](https://data.templateroller.com/pdf_docs_html/2016/20164/2016450/form-uitl-78-request-for-approval-of-work-share-plan-colorado.png "Form UITL-78 "Request for Approval of Work-Share Plan" - Colorado")
![Form UITL-39 "Employee-Leasing Company Application, Annual Report, and Certification" - Colorado](https://data.templateroller.com/pdf_docs_html/1764/17642/1764204/form-uitl-39-employee-leasing-company-application-annual-report-and-certification-colorado.png "Form UITL-39 "Employee-Leasing Company Application, Annual Report, and Certification" - Colorado")
![Form WC44 "Exclusion of Uncompensated Public Officials" - Colorado](https://data.templateroller.com/pdf_docs_html/1796/17965/1796506/form-wc44-exclusion-of-uncompensated-public-officials-colorado.png "Form WC44 "Exclusion of Uncompensated Public Officials" - Colorado")
![Form UITR-6a "Multiple Quarter Adjustment of Workers' Wages" - Colorado](https://data.templateroller.com/pdf_docs_html/321/3214/321449/form-uitr-6a-multiple-quarter-adjustment-workers-wages-colorado.png "Form UITR-6a "Multiple Quarter Adjustment of Workers' Wages" - Colorado")
![Form UITR-6C "Social Security Number Corrections" - Colorado](https://data.templateroller.com/pdf_docs_html/321/3214/321448/form-uitr-6c-social-security-number-corrections-colorado.png "Form UITR-6C "Social Security Number Corrections" - Colorado")
![Form WC34 "Request to Erase (Redact) Medical Information From an Audio Recording" - Colorado](https://data.templateroller.com/pdf_docs_html/1796/17965/1796502/form-wc34-request-to-erase-redact-medical-information-from-an-audio-recording-colorado.png "Form WC34 "Request to Erase (Redact) Medical Information From an Audio Recording" - Colorado")
![Form WC30 "Designated Health Care Provider Disclosure Form" - Colorado](https://data.templateroller.com/pdf_docs_html/1796/17965/1796501/form-wc30-designated-health-care-provider-disclosure-form-colorado.png "Form WC30 "Designated Health Care Provider Disclosure Form" - Colorado")
![Form WC15 "Workers' Claim for Compensation" - Colorado](https://data.templateroller.com/pdf_docs_html/1796/17964/1796492/form-wc15-workers-claim-for-compensation-colorado.png "Form WC15 "Workers' Claim for Compensation" - Colorado")
![Form WC18 "Dependent's Notice and Claim for Compensation" - Colorado](https://data.templateroller.com/pdf_docs_html/1796/17964/1796499/form-wc18-dependent-s-notice-and-claim-for-compensation-colorado.png "Form WC18 "Dependent's Notice and Claim for Compensation" - Colorado")
![Form WC37 "Petition to Reopen" - Colorado](https://data.templateroller.com/pdf_docs_html/1796/17965/1796505/form-wc37-petition-to-reopen-colorado.png "Form WC37 "Petition to Reopen" - Colorado")
![Form WC63 "Request for Offset of Liability to Subsequent Injury Fund" - Colorado](https://data.templateroller.com/pdf_docs_html/1796/17965/1796511/form-wc63-request-for-offset-of-liability-to-subsequent-injury-fund-colorado.png "Form WC63 "Request for Offset of Liability to Subsequent Injury Fund" - Colorado")
![Form WC70 "Application for Admission to the Colorado Major Medical Insurance Fund" - Colorado](https://data.templateroller.com/pdf_docs_html/1796/17965/1796512/form-wc70-application-for-admission-to-the-colorado-major-medical-insurance-fund-colorado.png "Form WC70 "Application for Admission to the Colorado Major Medical Insurance Fund" - Colorado")
![Form WC168 "Notice of Change of Carrier or Adjusting Firm" - Colorado](https://data.templateroller.com/pdf_docs_html/2078/20780/2078087/form-wc168-notice-of-change-of-carrier-or-adjusting-firm-colorado.png "Form WC168 "Notice of Change of Carrier or Adjusting Firm" - Colorado")
![Form WC192 "Motion to Close Claim for Failure to Prosecute" - Colorado](https://data.templateroller.com/pdf_docs_html/2078/20783/2078323/form-wc192-motion-to-close-claim-for-failure-to-prosecute-colorado.png "Form WC192 "Motion to Close Claim for Failure to Prosecute" - Colorado")
![Form B-491 "Overpayment Waiver Request" - Colorado](https://data.templateroller.com/pdf_docs_html/1788/17886/1788653/form-b-491-overpayment-waiver-request-colorado.png "Form B-491 "Overpayment Waiver Request" - Colorado")
![Form WC179 "Division Independent Medical Examination (Dime) Physician Summary Disclosure Form (Insurer or Self-insured Employer)" - Colorado](https://data.templateroller.com/pdf_docs_html/2078/20780/2078088/form-wc179-division-independent-medical-examination-dime-physician-summary-disclosure-form-insurer-or-self-insured-employer-colorado.png "Form WC179 "Division Independent Medical Examination (Dime) Physician Summary Disclosure Form (Insurer or Self-insured Employer)" - Colorado")
![Form WC165 "Notice of Dime Negotiations" - Colorado](https://data.templateroller.com/pdf_docs_html/2078/20780/2078086/form-wc165-notice-of-dime-negotiations-colorado.png "Form WC165 "Notice of Dime Negotiations" - Colorado")
![Form WC193 "Request for Disfigurement Award (Photo)" - Colorado](https://data.templateroller.com/pdf_docs_html/1788/17886/1788665/form-wc-193-request-disfigurement-award-photo-colorado.png "Form WC193 "Request for Disfigurement Award (Photo)" - Colorado")
![Form WC189 "Authorization for Release of Information" - Colorado](https://data.templateroller.com/pdf_docs_html/1789/17899/1789975/form-wc-189-authorization-release-information-colorado.png "Form WC189 "Authorization for Release of Information" - Colorado")
![Form WC190 "Authorization for Release of Limited Information to Third Parties" - Colorado](https://data.templateroller.com/pdf_docs_html/1789/17899/1789976/form-wc-190-authorization-release-limited-information-to-third-parties-colorado.png "Form WC190 "Authorization for Release of Limited Information to Third Parties" - Colorado")
![Form WC188 "Authorized Treating Provider's Request for Prior Authorization" - Colorado](https://data.templateroller.com/pdf_docs_html/1788/17886/1788666/form-wc-188-authorized-treating-provider-s-request-prior-authorization-colorado.png "Form WC188 "Authorized Treating Provider's Request for Prior Authorization" - Colorado")
![Form WC195 "Notification by an Authorized Treating Provider" - Colorado](https://data.templateroller.com/pdf_docs_html/1788/17886/1788667/form-wc-195-notification-by-an-authorized-treating-provider-colorado.png "Form WC195 "Notification by an Authorized Treating Provider" - Colorado")
![Form WC153 "Fatal Case - Final Admission" - Colorado](https://data.templateroller.com/pdf_docs_html/2078/20780/2078085/form-wc153-fatal-case-final-admission-colorado.png "Form WC153 "Fatal Case - Final Admission" - Colorado")
![Form WC174 "Worker's Claim for Compensation Transmittal" - Colorado](https://data.templateroller.com/pdf_docs_html/1788/17886/1788663/form-wc-174-worker-s-claim-compensation-transmittal-colorado.png "Form WC174 "Worker's Claim for Compensation Transmittal" - Colorado")
![Form WC196 "Rehabilitation Communication Form" - Colorado](https://data.templateroller.com/pdf_docs_html/1788/17886/1788668/form-wc-196-rehabilitation-communication-form-colorado.png "Form WC196 "Rehabilitation Communication Form" - Colorado")
![Form WC134 "Request for Services" - Colorado](https://data.templateroller.com/pdf_docs_html/1788/17886/1788661/form-wc-134-request-services-colorado.png "Form WC134 "Request for Services" - Colorado")
