Instructions for downloading:
1. The sections are separated by categories and forms that pertain to that section are listed in the boxes.
2. When you locate the form you need, click on the link for the specific format to download the form.
3. The formats are in Microsoft Word (Docx) or Adobe PDF.
If you need to install the Adobe Acrobat Reader Program , download the program from the Adobe site. (It is free to download).
Note: Your browser may ask you to allow pop-ups from this website. Allow the pop-ups and double-click the form again. Please use one of the following browsers for the best website compatibility (Microsoft Edge, Chrome, Firefox or Safari)
Mac Users: Safari may block pop ups by default. You can go to your Safari menu, choose preferences and then change your security setting to allow pop-ups.
Phone Users: Be sure you are in Hide Reader mode.

*Note: To Use Fillable Forms
When opening fillable forms, left click and check your downloads folder for the document. Fill out the form, save, and submit to Clerk of the Court.
Legal Forms - Mandatory
Please select the form and click on the link to download. Mandatory forms are rule-based forms.
Mandatory Forms

Application to Director (Docx)
Application to Workers' Compensation Judge

Application to Workers' Compensation Judge (Docx)
Complaint with Two Employers/Insurers

Complaint with Two Employers/Insurers (Docx)
Health Care Provider (HCP) Disagreement Form

Health Care Provider (HCP) Disagreement Form (Docx)
Informal Response

Informal Response (Docx)
Joint Request for Expedited Section 52-5-12 Hearing

Joint Request for Expedited Section 52-5-12 Hearing (Docx)
Notice of Acceptance or Rejection of Recommended Resolution

Notice of Acceptance or Rejection of Recommended Resolution (Docx)
Notice of Telephonic Conference Code

Petition for Lump Sum Payment

Petition for Lump Sum Payment (Docx)
Request for Setting

Request for Setting (Docx)
Mandatory Forms (Continued)

Subpoena (Docx)
Summons for Application to Director

Summons for Application to Director (Docx)
Summons for Application to Workers' Compensation Judge

Summons for Application to Workers' Compensation Judge (Docx)
Summons for Petition for Lump Sum Payment

Summons for Petition for Lump Sum Payment (Docx)
Summons for Workers' Compensation Complaint

Summons for Workers' Compensation Complaint (Docx)
Summons for Uninsured Employers' Fund (UEF) Complaint

Uninsured Employers' Fund (UEF) Complaint

Uninsured Employers' Fund (UEF) Complaint (Docx)
Workers' Authorization for Use and Disclosure of Health Records (HIPAA)

Workers' Authorization for Use and Disclosure of Health Records (HIPAA) (Docx)
Workers' Compensation Complaint

Workers' Compensation Complaint (Docx)
Legal Forms - Optional
Please select the form and click on the link to download.
Optional Forms

Change of Address

Change of Address (Docx)
Form Letter to Health Care Provider

Form Letter to Health Care Provider (Docx)
Joint Waiver of Disqualification

Joint Waiver of Disqualification (Docx)
Notice of Change of Health Care Provider

Notice of Change of Health Care Provider (Docx)
Notice of Disqualification

Notice of Disqualification (Docx)
Optional Forms (Continued)

Out of State Health Care Provider Affidavit (Docx)
ProSe Consent

ProSe Consent (Docx)
ProSe Revocation

ProSe Revocation (Docx)
Request for Late Reset of Mediation Conference

Stipulated Recommended Resolution

Worker's Response

Worker's Response (Docx)
Pre Litigation Report

Legal Forms - Packets
Notice: Forms found in packets are put together so that filers know what forms are needed. Despite forms being together in a packet, when e-filing, forms must be filed individually.
Please select the form and click on the link to download.

Formularios de NMWCA
Instrucciones para descargar
1. Las secciones están divididas entre categoría y los formularios que pertenecen a la sección respectiva se encuentran listadas en cada cuadro o caja.
2. Cuando encuentra los formularios que necesita, puede hacer clic en el título de los formularios para descargar. El título es un enlace activo.
3. Los formatos son (Docx) para Microsoft Word o para Adobe PDF.
Si necesita instalar el programa de Adobe Acrobat Reader , descargue el programa por medio del sitio web de Adobe. (Es un descargo gratis).
Nota: Es posible que su navegador le pregunte que permita pop-ups o elementos emergentes de este sitio web. Permita los pop-ups o elementos emergentes y haga doble clic en el formularios de nuevo. Por favor use unos de los navegadores siguientes para la mejor compatibilidad del sitio web (Microsoft Edge, Chrome, Firefox o Safari).
Usadores de Mac: Es posible que Safari bloquee los pop ups o elementos emergentes automáticamente. Para permitir los pop ups o elementos emergentes, vaya a su menú de Safari, seleccione preferencias y cambie/ ajuste sus preferencias de seguridad.
*Nota: Para Usar Los Formularios Rellenables
Cuando abra los formularios rellenables, haga clic a la izquierda y chequee su folder de descargos para el documento. Llene el formulario y enviarlo al secretario/a del tribunal.
Formularios Legales - Obligatorias
Por favor seleccione el formulario y haga clic el enlace para descargar. Formularios obligatorios son formularios basados por regla.
Formularios Obligatorias (Continuado)
Formularios Legales - Paquetes
Aviso: Formularios que se encuentran en paquetes son juntados para que el/la archivador(a) sepa cuales formularios se necesitan. Aunque los formularios serán juntados en un paquete, cuando haga e-file, las formas serán archivadas individualmente.
Por favor seleccione el formulario y haga clic el enlace para descargar.
Paquetes
Insurance Forms
Please select the form and click on the link to download.
Self-Insurance
Application - Individual (Docx)
Application - Group (Docx)
Board of Directors Resolution (Docx)
Letter of Credit - Individual (Docx)
Letter of Credit - Group (Docx)
Parental Guaranty for Subsidiaries (Docx)
Surety Bond - Individual (Docx)
Surety Bond - Group (Docx)
Data Reporting
Please select the form and click on the link to download.
Medical Forms

Notice of Inpatient Admission

Provider's Report of Physical Ability (PROPA)

Release for Health Care Records (HIPAA)

(Docx) Release for Health Care Records (HIPAA)
