Transfer of Care Card

Transfer of Care Card - (Forms/Publications)
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Title Transfer of Care Card (A fillable form - 20 KB PDF)

Used by injured worker to notify claim manager and request authorization to transfer care to a different doctor. Do it online! Use the online Transfer of Care

Form number F245-037-000
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Keywords attending physician, claims, espanol, industrial insurance, medical, new doctor, physician, provider, spanish, worker's compensation, workers compensation, workers' compensation
Languages English , Spanish
Valid dates 09-2012 , 04-2014
Contact information Managing Injured Workers' Claims
Claims for Job Injuries
Web pages For Medical Providers
Workers' Comp Claims

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