Provider Application and Notice for Spanish Speaking Providers Outside the United States- English/Spanish

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Title   Provider Application and Notice for Spanish Speaking Providers Outside the United States- English/Spanish (6.5MB PDF)
Description This form is to be used by Spanish speaking Medical Providers outside the United States. This form now includes both English and Spanish versions of the Provider form and letters. File includes W8ECI form from IRS and instructions for the form. Both IRS form and instructions are in English. Instructions in Spansih for the W8ECI have been added. This version is not the same as the English version, which is intended for use by Providers in the United States.
Detail
Form number F248-361-909
Availability
Online only. See document above to download.
Keywords doctor, interpreter, physician, physician assistant
Languages Spanish
Valid dates 09-2008
Contact information Managing Injured Workers' Claims
Claims for Job Injuries
Web pages For Medical Providers

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