This form is used to log into the Consent form. if you’re unable to locate your Employee ID, please call 1.800.427.0798 Claimant ID:*The Notice you received will have your Claimant ID listed.Employee ID or Last Four of SSNThis field is hidden when viewing the formEntry Verification*This field is hidden when viewing the formNotice Type*This field is hidden when viewing the formLast Name*This field is hidden when viewing the formIs Valid Entry* Yes CAPTCHA