Case Transfer Card (Spanish) Tarjeta para transferencia de caso
 

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Título Case Transfer Card (Spanish) Tarjeta para transferencia de caso (80 KB PDF)
Descripción Used by injured worker to notify claim manager and request authorization to transfer care to a different doctor.
Detalle
Número del formulario F245-037-999
Disponibilidad ordénelo
Palabras claves attending physician, authorization, case transfer, claims, doctor, espanol, industrial insurance, injured worker, insurance, medical, new doctor, physician, provider, spanish, transfer, worker's compensation, workers compensation, workers' compensation
Idiomas Spanish , English
Fechas válidas 03-2007
Contacto Managing Injured Workers' Claims
Claims for Job Injuries
Páginas de Internet For Medical Providers
Workers' Comp Claims