Workers Compensation Forms & Questionnaires

Client’s retaining The Lockwood Legal Group to represent them in Workers Compensation Cases should complete the below Employment Contracts, forms, and questionnaires.

The below linked documents are password protected. You should have received a password from your attorney. If you lost or cannot remember said password, contact us. We will help you.

You will also need to sign a Health Information Privacy (HIPA) Form. The law requires a hand written signature on the HIPA form. You can download it here and print it out and sign.

If you do not have a printer, tell your attorney. A paper copy will be mailed to you.

Other authorizations might become necessary for you to sign. Your attorney will have you sign these additional forms as your case progresses.

Employment Contracts

Choose the contract applicable to which state you work in.

Workers Compensation Contingency Agreement – Indiana Clients

Workers Compensation Contingency Agreement – Michigan Clients

Proof of Representation Agreement

Litigation Expense Indemnification Agreement

Questionnaires

Client Information Questionnaire

Workers Compensation Questionnaire

Damages Bodily Injury

Damages Unpaid Bills Expenses

Damages Employment and Income