Chemical Exposure Questionnaire Packet


Document Information
  Get help downloading & printing files.   How to complete a fillable form.
Title Chemical Exposure Questionnaire Packet
Description

Packet that contains:

F242-409-000 Chemical Exposure Questionnaire

F242-410-000 Worker Release for Union Dispatch Records

F262-005-000 Authorization to Release Information

Request for Social Security Earnings Information with the L&I address.

Document number F242-409-000
How to get this document
Keywords chemical
Alt Language(s) Español
Valid dates 04/2014
Contact information Claims for Job Injuries
Websites

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.