Safety Reporting Forms & Claim Documents

Industrial Injury Forms & County Claim Documents

These forms are designed for the reader to enter limited information. Please note that when the cursor is placed into a writable field, there is a note at the bottom of the screen that will indicate the maximum number of characters that may be entered. You will not be allowed to enter more characters even if you create more space using the 'enter' key.

After completing your entries, you can either print the document or save it to a designated drive on your computer. You will also receive a prompt regarding saving or discarding the changed form if you close the window after entering any information.

These forms are only for the Maricopa County Government and it's employees. All others access the Notice of Claim Form.

Safety Reporting Forms - Internal Use Only

  • Locate Accident Investigation Forms
  • Access Industrial Injury Forms
  • See information regarding Workers' Compensation
  • View a list of FastMed locations

County Claim Documents - Internal Use Only

  • Auto Loss Online Form
  • General Liability Loss Online Form
  • Property Loss Online Form

Vehicle Use Permit Forms - Internal Use Only

  • Vehicle use Permit Forms

Job Safety Analysis (JSA)

The following information is non-proprietary can be used by anyone. Job Safety Analysis (JSA) is a method that can be used to identify, analyze and record:
  • The steps involved in performing a specific job.
  • The existing or potential safety and health hazards associated with each step.
  • The recommended action(s)/procedure(s) that will eliminate or reduce these hazards and the risk of a workplace injury or illness.
Use the following link for more information:
  • Job Safety Analysis (JSA) Description and Form