All Forms

Below is a list of downloadable forms for our members’ convenience. Unless otherwise stated on the form, these forms must be mailed to:


Los Angeles Firemen’s Relief Association
P. O. Box 41903
Los Angeles, CA 90041

or faxed to (323) 259-5290 / DO NOT send any medical personal health information (PHI)

FAX Numbers

  • Add/Drop Dependent (323) 259-5297
  • Flu Vaccine Claim Form  (559) 499-2464 or (323) 259-5295
  • Green Form / Unprocessed Medical Expenses Claim Form (CA) (559) 499-2464 or (323) 259-5295

Relief Forms

Medical Forms

Back to Top