Welfare Forms
Please Note: In order to view and print the following forms, you must have the Adobe Acrobat Reader installed on your computer. If you
do not have the Adobe Acrobat Reader Software and wish to download it, you may do so by clicking on the image below.
- Accidental injury Questionnaire
- American Health Med Review Request
- American Health Medical Management Services Referral
- Change of Address
- Coverage Election Form, Tier 2, Local 22
- Coverage Election Form, Tier 2, Local 772
- Medicare Information Form
- Pension Deduction Authorization Request
- Yearly Coordination of Benefits and Dependent Status