Election of Healthcare Provider for Workplace Injuries
Last Updated | February 8, 2023 |
Total Files | 1 |
Version | 2023 |
This form can be used by employees who to indicate that, in the event of an on-the-job injury, the employee would either (A) prefer to be treated by the Company's designated physician or (B) prefer to be treated by their own designated healthcare provider.
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Download
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NHF10012.2 Election of Healthcare Provider for Workplace Injuries.pdf |
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