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Workers Comp

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DWC 1 form

If Medical treatment is not being requested:  Complete Number 2 and Number 6 .  

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If Medical treatment is requested you must:  Complete forms 1-5  below and return to HR. 

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CONCENTRA- URGENT CARE MAP AND FORM

MPN Acknowledgement 

Right to Workers Comp

MEDICAL PROVIDER NETWORK

PACKET. CORVEL

Treatment Waiver form

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