Medical Forms

Below is a list of downloadable Medical forms for 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


Add/Drop Dependent FAX to (323) 259-5297
Flu Vaccine Claim Form  FAX to (323) 259-5295
Unprocessed Medical Expenses Claim Form For CA Members (Green Form) FAX to (323) 259-5295



Back to Top