This is an acknowledgement form regarding workers' compensation. The form states that the employee has read and understands the workers' compensation guidelines.
Para su conveniencia, debajo del texto en español le brindamos la versión completa de este formulario en inglés.
For your convenience, the complete English version of this form is attached below the Spanish version.
The Workers' Compensation Acknowledgment Form is a document that folks fill out to confirm they understand their rights and responsibilities under Ohio's workers' comp laws.
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Cincinnati Ohio Formulario de Reconocimiento de Compensación para Trabajadores