Medical Device Review Request
See also
| Document Information | ||
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 Get help downloading & printing files.  How to complete a fillable form. |
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| Title | Medical Device Review Request | |
| Description | 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. |
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| Document number | F252-013-000 | |
| How to get this document |
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| Keywords | attending doctor, attending physician, injured worker, medical device, medical forms, physician assistant, provider | |
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| Valid dates | 04/1997 | |
| Contact information | Claims for Job Injuries, Employer Services | |
| Websites | For Medical Providers | |
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