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 lets employees know their rights and responsibilities if they get hurt at work. It's like a heads-up on what to expect when it comes to workers' comp.
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Mesa Arizona Formulario de Reconocimiento de Compensación para Trabajadores