Election of Healthcare Provider for Workplace Injuries

Last UpdatedJuly 10, 2020
Total Files1
Version2020

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.

Want to leave the hassle of assembling onboarding documents behind? Learn more about ManagEase's streamlined Blue Rock Employee Documentation System.


Download
File
NHF10012.2 Election of Healthcare Provider for Workplace Injuries.pdf
Note: This sample form is provided as a tool for employers. This form is general in nature, and may not be required by law. ManagEase is not a law firm. This form does not constitute legal advice, nor is any attorney-client relationship created or implied. Prior to using this form, we recommend that you consult with an attorney knowledgeable in any potentially applicable federal and/or state laws regarding the specific intended use of this form.
0 replies

Leave a Reply

Want to join the discussion?
Feel free to contribute!

Leave a Reply

Your email address will not be published. Required fields are marked *