225 East Emporia
Ponca City, Okahoma 74601

Maintenance Director - Tony Smith - 580-718-3982

Maintenance Secretary - Pam McEnany - 580-718-3980

Maintenance & Risk Management Forms

Risk Management

OSAG - Oklahoma School Assurance Group provides the Workers' Compensation Insurance for the district.

For information contact Bret Smith, Risk Management, at 580-767-8000 or 580-767-8085.

Workers' Compensation Forms:

Witness/Co-Workers Statement - PRINT ON GREY PAPER

Report of Occupational Injury or Illness (for workers' comp) - PRINT ON GREY PAPER

Authorization for Disclosure of Protected Health Information - PRINT ON GREY PAPER

Mandatory Medicare Reporting Requirement - PRINT ON GREY PAPER

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