Medical Device Review Request

Document Information
  How to complete a fillable form.
Title Medical Device Review Request

This form is so L&I's Office of the Medical Director can evaluate medical device(s) that the attending physican wants to use to treat an injured worker.

Document number F252-013-000
How to get this document
Alt Language(s)
Valid dates 04/1997
Contact information Claims for Job Injuries , Treating Injured Workers
Websites For Medical Providers

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