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Personal Risk Forms

Click on any of the links below to download the corresponding form.

Accident and Health

  • Accident and Sickness for Volunteers Application
  • International Campers & Miscellaneous Activities Application
  • Miscellaneous Accident Application
  • Pathfinder International Application
  • Short Term Travel Application
  • Volunteer Labor Application
  • The North American Division of the Seventh-Day Adventists- Summer Camps Brochure/Application (This is a .ZIP archive that you must first uncompress to use)

North American Division Employee Forms

  • Employee Benefits Contact Information (MS Word)
  • Retiring/Terminating Employee -- checklist (PDF)

Accidental Death and Dismemberment

  • Accidental Death and Dismemberment Claim
  • Accidental Dismemberment or Loss of Sight Claim
  • AD& D Certificate of Coverage
  • AD & D Conversion Information and Instructions
  • AD & D Conversion Form
  • Children with Disabilities
  • Hartford AD & D Enrollment
  • Hospital Indemnity–AD & D
  • Pilot History PA 1754
  • Voluntary AD & D Benefit Highlight Sheet
  • Waiver of Premium Claim Form

Group Life Insurance

  • 2005 Policy Endorsement
  • Accelerated Death Benefit Option Disclosure
  • Beneficiary Assist
  • Beneficiary Designation
  • Children with Disabilities
  • Consent Form for Payment of Accelerated Death Benefits
  • Consent Form for Payment of Living Benefits
  • Florida Beneficiary Designation
  • Group Life Policy
  • Living Benefits Claim
  • Notice of Conversion Privilege
  • Proof of Death
  • Proof of Death–Dependent
  • Travel Assistance/ID Wallet Card
  • Waiver of Premium Claim

Long Term Disability

  • Ability Assist
  • Application for Long Term Disability Income Benefits Form
  • Premium Waiver Form
  • LTD 90-day policy (effective 1/1/08)
  • Notice of Conversion Privilege Form
  • Complex Claim Advice–Submission Form

Supplemental Life Insurance

  • Accelerated Death Benefit Option Disclosure Form
  • Beneficiary Assist
  • Beneficiary Designation Form
  • Children with Disabilities
  • Consent Form for Payment of Accelerated Death Benefits
  • Consent Form for Payment of Living Benefits
  • Group Term Life Brochure
  • Hartford Supplemental Life Enrollment Form
  • Hartford Portability Rates
  • Life Portability Form
  • Life Conversion Form
  • Living Benefits Claim Form
  • Personal Health Application (excluding CA and NY)
  • California Personal Health Application - CA residence only
  • New York Personal Health Application
  • Porting vs. Converting
  • Proof of Death–Dependent Form
  • Proof of Death Form
  • Retiree Enrollment Form
  • Supplemental Life Benefit Highlights Sheet
  • Supplemental Life Certificate of Coverage
  • Waiver of Premium Claim Form

Main Menu

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©2010 Adventist® Risk Management, Inc. | 12501 Old Columbia Pike | Silver Spring, MD 20904
Seventh-day Adventist Church