Forms
 

Forms needed to complete a Workers' Compensation Claim

Incident Report

Witness Statement

Medical Information Release Authorization

 

If you have any questions concerning these forms you may contact the bookkeeper at your work location or Connie Jordan - Workers' Compensation Specialist at District Office  (843-488-6850).

Horry County Schools

335 Four Mile Rd. | PO Box 260005 | Conway, SC 29528

Phone 843-488-6700

Horry County Schools does not discriminate on the basis of race, religion, color, national origin, sex, disability, age, immigrant status, English-speaking status, or any other characteristic protected by applicable federal or S.C. law in its programs or activities. For questions regarding the nondiscrimination policies call 843-488-6700, or write Horry County Schools, 335 Four Mile Rd., Conway, SC 29526 or click here for a list of contacts.

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