Medical Forms

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Oregon Teamsters Employers Trust – Enrollment Form

Enroll in or update medical coverage, dependent information, and beneficiary information.

Oregon Processors Employees Trust – Time Loss Claim

Statement of claim for time-loss benefits, including employee, employer, and attending physician sections.

Teamsters Western Region & Local 177 – Short-Term Disability

Short-term disability and continued health-coverage instructions and claim forms.

United Employees Benefit Trust – Medical, Vision & Time Loss

Enrollment and coverage-change form for medical, vision, time-loss, and dependent benefits.

Washington Teamsters Welfare Trust – Enrollment Form

Annual enrollment and dependent-update form for Washington Teamsters health and dental coverage.

Washington Teamsters Welfare Trust – Disability Waiver

Weekly income and disability-waiver application with employee and employer sections.