Transfer of Care Card

Document Information
  How to complete a fillable form.
Title Transfer of Care Card

Used by injured worker to notify claim manager and request authorization to transfer care to a different doctor. Do it online! Use the online Transfer of Care

Document number F245-037-000
How to get this document
  • Order it from our Warehouse
  • Alt Language(s) Español
    Valid dates 04/2014, 09/2012
    Contact information Claims for Job Injuries , Managing Injured Workers' Claims
    Websites For Medical Providers , Workers' Comp Claims

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