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Click ‘Get Form’ to open the CA-1 form in the editor.
Begin by filling out your personal information in boxes 1-15. Ensure you provide your full name, date of birth, and email address for communication purposes.
In section 9, describe where the injury occurred. Be specific about the location to ensure clarity.
For section 13, detail the cause of your injury. Include any relevant circumstances that led to the incident.
Complete section 15 by certifying that the injury was sustained while performing your duties. Check any applicable benefits you are claiming.
If applicable, have a witness complete section 16 with their statement regarding the incident.
Finally, review all entries for accuracy before saving or printing your completed form.
Start using our platform today to streamline your CA-1 form completion!
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