Obtenga un formulario o publicación: hearing services

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Hearing Aid Repair Authorization Fax Request


Hearing Aid Repair Authorization Requests. If you need to purchase or replace a hearing aid, fax all of the information required by Medical Aid Rules and Fee Schedule (MARFS) including the Hearing Services Worker Information (F245-049-000) to 360-902-6252.

Form F245-384-000
Hearing Services Worker Information

This is a list of the rights and conditions when an injured worker applies for hearing aids.

Form F245-049-000
Termination of Agreement (Rescission)

To be filled out by the injured worker who wants to return hearing aids.

Form F245-050-000

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