IPRF Documents and Forms

On this page you will find available documents and forms from IPRF. Please click on any form or document to download what you need.

• Complete Claims Kit

The Claims Kit includes Reporting Procedures, Illinois Claim Form 45, Completion Instructions, Medical Authorization, Wage Statement and IPRF Problem Claims Form. To download a part of the kit, please click on the proper form or document below:

• Reporting Procedures
• Illinois Claim Form 45
• Completion Instructions
• Medical Authorization
• Wage Statement
• IPRF Problem Claims Form

Other Documents and Forms:

• Notice to Employee Poster
• HFN
• NPS Pharmacy
• IPRF Grant Program Brochure
• Grant Program Application Form
• Grant Program Preferred Vendors
• Grant Program Vendor Application
• Helping Hands Matching Grant Program
• Application for the Matching Grant
  IPRF Driving Simulator Training.pdf