Forms - Golden State Risk Management Authority

Forms

Claim Forms

Instructions - How to Fill Out the Proper Claim Form

Workers' Compensation Claims Forms

Cal/OSHA Logs

DWC1 Claim Form

Form 5020 (English)

Medical Mileage Form - 2025 (English/Spanish)

Time of Hire Pamphlet (DWC)

General Liability & Property Loss Claims Forms

Accident/Incident Form (schools only) Auto Loss Notice Form Claim for Damages Incident Report Property Loss Notice Form

Employee Benefits Forms

GSRMA Employee Benefits Enrollment Form GSRMA Health Benefits Program - Brochure GSRMA Health Benefits - Trifold

Loss Prevention Forms

Loss Prevention Fund Application Risk Management Accreditation Program (RMAP)School District Training Matrix

Member Services Forms

Volunteer Workers’ Compensation Coverage – Information Page Workers’ Compensation Coverage for Unpaid Volunteers – Declination Workers’ Compensation Resolution – Board Only Workers’ Compensation Resolution – Board and Volunteers Workers’ Compensation Resolution – Volunteers Only

Miscellaneous Forms

Member Expense Form 2025

Miscellaneous Resources

Insurance Requirements in Contracts (IRIC) Manual