1820 East 1st Street
Santa Ana, CA 92705
714-569-2700
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Report a Claim

To report a claim, click on one of the form links below:

To report a Workers Compensation Claim, download the following pdf. After completing the form, print and fax to 714-784-1550. Or scan and email to jaylene-valentine@leavitt.com

Workers Compensation Claim
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