Crime Victims Compensation Program Termination Report: Form VI


Crime Victims Compensation Program Termination Report: Form VI

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Title	Crime Victims Compensation Program Termination Report: Form VI (A fillable form - 57 KB PDF)
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
Keywords	clinical, crime victim compensation, crime victims compensation, cvc, industrial insurance, insurance, provider, termination, treatment, victim, worker's compensation, workers compensation, workers' compensation
Languages	English
Valid dates	07-2005
Contact information	Crime Victims Compensation
Web pages	Help for Crime Victims