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¿Necesita un doctor?
Publication
F160-006-999

World Language(s):
Inglés  
Approved Independent Medical Examiner (IME) Update
Form
F245-051-000  
Attending Doctor's Handbook
Publication
F252-004-000  
Attending Doctor's Handbook
Publication
F252-004-000  
Cholinesterase Monitoring Health Care Provider Recommendations
Form
F413-070-000

World Language(s):
Español
Español  
Comentarios Sobre el Exámen Médico Independente
Form
F245-053-999

World Language(s):
Inglés  
Doctor's Worksheet for Rating Cervical and Cervico-Dorsal Impairment
Form
F252-056-000  
Formulario para trasferencia de proveedor principal para trabajadores autoasegurados
Form
F207-114-999

World Language(s):
Inglés  
Formulario para trasferencia de proveedor principal para trabajadores autoasegurados
Form
F207-114-999

World Language(s):
Inglés  
Formulario para trasferencia de proveedor principal para trabajadores autoasegurados
Form
F207-114-999

World Language(s):
Inglés  
Formulario para trasferencia de proveedor principal para trabajadores autoasegurados
Form
F207-114-999

World Language(s):
Inglés  
Independent Medical Exam Doctor's Estimate of Physical Capacities
Form
F242-387-000  
Independent Medical Examination (IME) Provider Exam Sites
Form
F245-047-000  
Medical Device Review Request
Form
F252-013-000  
Monitoreo de la colinesterasa - recomendaciones del proveedor médico (ejemplo)
Form
F413-070-999

World Language(s):
Inglés
Inglés  
Non-Network Provider Application
Form
F248-011-000  
Out of Country Provider Application
Form
F248-361-000

World Language(s):
Español  
Provider Account Application - Independent Medical Examiner (IME)
Form
F245-046-000  
Solicitud de cuenta para proveedores fuera del país
Form
F248-361-999

World Language(s):
Inglés  
Solicitud de cuenta para proveedores fuera del país
Form
F248-361-999

World Language(s):
Inglés  
Tarjeta para transferencia de caso
Form
F245-037-999

World Language(s):
Inglés  
Transfer of Attending Provider Form for Self Insured Workers
Form
F207-114-000

World Language(s):
Español  
Transfer of Attending Provider Form for Self Insured Workers
Form
F207-114-000

World Language(s):
Español  
Transfer of Attending Provider Form for Self Insured Workers
Form
F207-114-000

World Language(s):
Español  
Transfer of Care Card
Form
F245-037-000

World Language(s):
Español  
Travel Reimbursement Request
Form
F245-145-000

World Language(s):
Español  
Attending Provider's Return-to-Work Desk Reference
Publication
F200-002-000  
Attending Provider's Return-to-Work Desk Reference
Publication
F200-002-000  
Helping Providers Understand the Crime Victims Compensation Program
Publication
F800-102-000  
Hotline Tips for Medical Services Providers
Publication
F248-040-000  
Hotline Tips for Medical Services Providers
Publication
F248-040-000  
Independent Medical Exam Comments
Form
F245-053-000

World Language(s):
Español  
Provider Network Agreement
Form
F245-397-000  





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