Site Map | Search | Phone Directory | Departments | Services

About Us
Risk Management
Administration Division
Claims Division
Environmental Division

Safety Division


Other Information

Safety Links
Employee Safety Hotline
Safety Reporting Form
Safety Data Sheets
Job Safety Analysis
Safety Conference

Other Links
Arizona Department of Occupational Safety and Health
Environmental Protection Agency
U.S. Department of Transportation

Center for Disease Control


Industrial Injury Forms & County Claim Documents

These documents are formatted in Microsoft Word. Accessing any of these forms will open a new window. The forms are designed for the reader to enter limited information. Please note that when the cursor is placed into a writable field, there is a note at the bottom of the screen that will indicate the maximum number of characters that may be entered. You will not be allowed to enter more characters even if you create more space using the 'enter' key.

After completing your entries, you can either print the document or save it to a designated drive on your computer. You will also receive a prompt regarding saving or discarding the changed form if you close the window after entering any information.

These forms are only for the Maricopa County Government and it's employees.
All others Click "HERE" for the Notice of Claim Form.

Safety Reporting Forms - Internal Use Only

For information regarding Workers' Compensation, please click "HERE"

For a list of FastMed locations, please click "HERE"

County Claim Documents - Internal Use Only
Vehicle Use Permit Forms - Internal Use Only
Job Safety Analysis (JSA)

The following information is nonproprietary can be used by anyone.

Job Safety Analysis (JSA) is a method that can be used to identify, analyze and record:

  • The steps involved in performing a specific job.
  • The existing or potential safety and health hazards associated with each step.
  • The recommended action(s)/procedure(s) that will eliminate or reduce these hazards and the risk of a workplace injury or illness.
Use the following link for more information.

Updated 02 Apr 2015, jrr

  Maricopa Home      Site Map      Legal Information      Privacy/Security Policies
Maricopa County Home Page
Maricopa County || 301 W. Jefferson St. || Phoenix, AZ 85003