Vocational Providers Application and Notice

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Title Vocational Providers Application and Notice (A fillable form - 463 KB PDF)
Description

Used to obtain a vocational provider account number with L&I. This form includes a copy of F248-036-000 "Request for Taxpayer ID number and Certification". (12 pages) CURRENT EXISTING VOCATIONAL PROVIDER FIRMS THAT ARE ALREADY REGISTERED WITH L&I USE THIS FORM AND W-9.
Detail
Form number F252-017-000
Availability
Online only. See document above to download.
Keywords Identification Number, industrial insurance, vocational, vocational provider
Languages English
Valid dates 01-2007
Contact information Vocational Resources
Related information
Documents Medical Forms Request
Job Modification Assistance Application

Pre-Job Accommodation Assistance Application


Individual Vocational Provider Account Change Form


Firm Vocational Provider Account Change

Employer's Job Description


Intent to Hire Preferred Worker
Intent to Hire Preferred Worker with Developmental Disabilities
Preferred Worker Employers Job Decsription

Request for Preferred Workers Status
Web pages For Vocational Counselors

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