Transfer of Care Card

Document Information
  How to complete a fillable form.
Title Transfer of Care Card

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

Document number F245-037-000
How to get this document
Alt Language(s) Español
Valid dates 04/2014, 09/2012
Contact information Claims for Job Injuries, Managing Injured Workers' Claims
Websites For Medical Providers, Workers' Comp Claims

End of main content, page footer follows.

Access Washington official state portal

  © Washington State Dept. of Labor & Industries. Use of this site is subject to the laws of the state of Washington.