Crime Victims Compensation Program Termination Report: Form VI
See also
| Document Information | ||
|---|---|---|
 Get help downloading & printing files.  How to complete a fillable form. |
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| Title |
Crime Victims Compensation Program Termination Report: Form VI (A fillable form - 65 KB PDF)
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| Description | Used by the clinical provider to inform L&I that you are no longer conducting treatment to the client. This must be submitted within 60 days of the client's last session and you are no longer conducting treatment. | |
| Detail | ||
| Form number | F800-085-000 | |
| Availability | Online only. See document above to download. |
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| Keywords | cvc, Form IV, industrial insurance, worker's compensation, workers compensation, workers' compensation | |
| Languages | English | |
| Valid dates | 06-2011 | |
| Contact information |
Crime Victims Compensation
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| Web pages | Help for Crime Victims | |
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