Vermont.gov
Vermont.gov
   
Employer Portal Claimant Portal
   You Are Here: Forms & PublicationsWC Forms and Publications
* Worker's Compensation Forms and Publications *
*
All of our forms are available in Adobe PDF format.  If you do not have a PDF reader, you can download a free one from Adobe
*
* Workers' Compensation *
* *
* Alternative Dispute Resolution *
*
Workers' Compensation Alternative Dispute Resolution Report

This report must be filed within 15 days of completion of the mediation.

If you want to submit this form electronically please save it and attach it to an e-mail to Phyllis Phillips at phyllis.phillips@state.vt.us.


*
Accessibility Policy Users with Special Needs Privacy Policy Copyright Information Site Map
Equal Opportunity is the Law. A Vermont Government Website.
©2005 State of Vermont. All rights reserved. Admin
Vermont.govState of Vermont Department of Labor