Forms

Alabama

These forms are included in your injured worker packet.

First Report of Injury
This form is used to report a work-related injury or illness to Summit. The copy in your injured worker packet includes the information given to Summit when your injury was reported to us. Keep that copy for your records.

Travel Reimbursement
Your mileage may be reimbursed for travel to and from a medical provider. To receive this benefit, you must complete this form and return it to Summit.