New Company Setup Request

In order to streamline the new company setup process, we've created the following web form to capture key information.  Please fill out as much information as you can, and send additional inquiries to

In addition to the form below, please also send the below to

  1. Eligibility file or census file of employee information (name, email, phone #)
  2. Company logo


New Company Specific Information
i.e. when someone calls the hotline where does it go?
Who is in the group that should know when a new incident is called or texted in
Who do you want to be able to see and create incident reports? Who do you think will be doing "the work"
Probably need 2 meetings, each about 30 minutes to walk through the system and answer questions.

Thank you - any and all questions can be directed to the Aclaimant team.