Claim Forms for 志愿者s

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This process is for volunteers only!

vfi标志If you are an authorized Doña安娜县 volunteer for the 火 Department or Sheriff’s Department please read the following directions below before clicking the links.

VFIS- Sheriff and 火fighter 志愿者s Claim Form

There are two things you need to do:

  1. Get medical treatment as needed. See directions below.
  2. Report the injury or illness. See directions below.

Getting Medical Treatment – Emergency v. 非紧急

  1. If the injury requires emergency care immediately call 911 or go to the nearest ER.
  2. Notify your supervisor. Your supervisor or his/her designee shall transport you to your first visit to the medical provider. (see options below), or to the nearest urgent care facility.
    1. 地中海的工作
      开放时间:8小时.m. – 5 p.m. 星期一至星期五
      位于:2525s. Telshor大街. 新墨西哥州拉斯克鲁塞斯
      (575) 521-1919
    2. Any Urgent Care Facility
  3. Make sure that a drug and alcohol screening is conducted at the medical facility you are receiving treatment at. In the event the medical facility refuses the screening, it is your responsibility to make arrangements with WorkMed to have it done.
    1. Note: WorkMed is available on-call to complete the screening.

Reporting the Injury

  1. Your supervisor has been instructed to fill out a Notice of Accident on El Sol, which will inform Legal of your injury.
  2. You are responsible for filling out the Claim Form.
  3. If you are a Sheriff’s Department volunteer click on the “Sheriff” link above.
    If you are a 火 Department volunteer click on the “火” link above
  4. You will need to fill out the claim form in its entirety and provide it to the Legal Department for processing. You can fax it to (575) 525-5965, or hand-deliver it to a Legal representative.
  5. It is your responsibility to get the claim form to Legal to be processed. If you do not fill out the Claim Form we cannot process your claim with the insurance.
  6. If you have any questions or concerns contact the Legal Department at (575) 647-7225.

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