Get the free Accident & Health First Notice of Claim Form - Provident
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FIRST NOTICE OF CLAIM PROVIDENT AGENCY, INC. 272 ALPHA DRIVE P.O. BOX 11588 PITTSBURGH, PA 15238 TOLL-FREE: 800-447-0360 PHONE: 412-963-1200 CLAIMS DEPT FAX: 412-963-0148 www.providentbenefits.com
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Accident & Health First is a form that must be filed by employers with the relevant authorities to report any accidents or health incidents that occur in the workplace.
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Information such as date, time, location, nature of the accident or health incident, and details of the individuals involved must be reported on Accident & Health First forms.
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