Navigate Up
Sign In


​Authorization To Release Information.pdf Download
​Company Nurse Wallet Card Template.pdf Download​
​Company Nurse First Report Poster Template.pdf ​​Download
​Employee Injury or Illness Notification.pdf Download​​
​Employer Investigation Report.pdf Download
​Mileage Form.pdf ​Download​
Patient Status Report.pdf ​Download​
​Wage Statement.pdf Download​​

Model Programs are found in the Loss Control section of this site.

Templates for Company Nurse Wallet Cards and Posters are available for download or contact​ to have IWMCA print these for you.​

Newsletter Sign Up
Subscribe to the Informer

Contact Information

Phone: (800) 257-2708
Fax: (978) 367-2862
Administered by the Iowa League of Cities