Occupational or Physical Therapy Treatment Authorization Fax Request


Occupational or Physical Therapy Treatment Authorization Fax Request

Document Information
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Title	Occupational or Physical Therapy Treatment Authorization Fax Request (A fillable form - 308 KB PDF)
Description	Used by a therapy provider/clinic to request authorization for outpatient occupational or physical therapy services for L&I claims.
Detail
Form number	F248-055-000
Availability	Online only
Keywords	authorization, injured worker, occupational therapy, physical therapy, therapist, therapy, treatment
Languages	English
Valid dates	07-2008
Contact information	Managing Injured Workers' Claims
Web pages	For Medical Providers