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    Danae Hammitt   

Stay-at-Work/Return-to-Work Forms

 Employer-at-Injury Program
    Employer-at-Injury Reimbursement Request Form (2360)

 Preferred Worker Program
    Acuerdo de compra de articulos necesarios para el empleo de trabajador preferido (2350s) (2350s)
    Preferred Worker Employment Purchase Agreement (2350)
    Preferred Worker Job Offer Letter (4903)
    Preferred Worker Moving Assistance Agreement (3293)
    Preferred Worker Placement Assistance Agreement (4875)
    Preferred Worker Program Quarterly Claim Cost Reimbursement Request (3014)
    Preferred Worker Program Quarterly Claim Cost Reimbursement Request (3014-extra page)
    Preferred Worker Program Wage Subsidy Reimbursement Request (2968)
    Preferred Worker Wage Subsidy Agreement (2190)
    Preferred Worker Worksite Creation Agreement (4122)
    Trabajador preferido - acuerdo de sueldo subsidiado (2190s) (2190s)

 Vocational Assistance
    Request for Approval of Training Program by Vocational Rehabilitation Counselor (4619)
    Return-to-Work Plan; Direct Employment (1083)
    Return-to-Work Plan; Training (1081)
    Vocational Assistance Certification Program Individual Certification under OAR 436-120 (1880)
    Vocational Assistance Certification Program Registration of Vocational Assistance Provider (2814)
    Vocational Closure Report (2800)

Who's Who in SAW/RTW


If you have questions about this webpage, please contact Danae Hammitt, 503-947-7018.