Establishing secure connection…Loading editor…Preparing document…
We are not affiliated with any brand or entity on this form.
Workers Request to Change Attending Physician or Authorized Nurse Practitioner Oregon  Form

Workers Request to Change Attending Physician or Authorized Nurse Practitioner Oregon Form

Use a Workers Request To Change Attending Physician Or Authorized Nurse Practitioner Oregon template to make your document workflow more streamlined.

How it works

Open form follow the instructions
Easily sign the form with your finger
Send filled & signed form or save
What is a W-9 tax form? What is a W-9 tax form?

What is the Workers Request To Change Attending Physician Or Authorized Nurse Practitioner Oregon

The Workers Request To Change Attending Physician Or Authorized Nurse Practitioner in Oregon is a formal document that allows employees to request a change in their medical provider for workers' compensation cases. This form is essential for ensuring that workers receive appropriate medical care and support during their recovery process. It serves as a communication tool between the employee, the current provider, and the new provider, facilitating a smooth transition in medical care.

Steps to Complete the Workers Request To Change Attending Physician Or Authorized Nurse Practitioner Oregon

Completing the Workers Request To Change Attending Physician Or Authorized Nurse Practitioner form involves several key steps:

  • Gather necessary information: Collect details about your current physician or nurse practitioner, including their name, contact information, and any relevant case numbers.
  • Identify the new provider: Choose a new attending physician or authorized nurse practitioner. Ensure they are approved by your employer or the workers' compensation insurance provider.
  • Fill out the form: Accurately complete all sections of the form, including your personal information, current provider details, and new provider information.
  • Sign and date the form: Your signature is required to validate the request. Ensure that you date the form appropriately.
  • Submit the form: Send the completed form to your employer’s human resources department or the workers' compensation insurance carrier, following their submission guidelines.

Legal Use of the Workers Request To Change Attending Physician Or Authorized Nurse Practitioner Oregon

This form is legally binding when completed and submitted according to Oregon's workers' compensation laws. It ensures that the rights of the employee are protected while allowing for necessary changes in medical care. Compliance with state regulations is crucial, as improper use of the form may lead to delays in receiving medical treatment or complications in the workers' compensation claim process.

Key Elements of the Workers Request To Change Attending Physician Or Authorized Nurse Practitioner Oregon

Several key elements must be included in the Workers Request To Change Attending Physician Or Authorized Nurse Practitioner form:

  • Employee information: Full name, address, and contact details.
  • Current provider details: Name and contact information of the attending physician or authorized nurse practitioner.
  • New provider information: Name and contact details of the new physician or nurse practitioner.
  • Reason for change: A brief explanation of why the change is being requested.
  • Signature: The employee's signature and date to validate the request.

State-specific Rules for the Workers Request To Change Attending Physician Or Authorized Nurse Practitioner Oregon

In Oregon, specific rules govern the process of changing an attending physician or authorized nurse practitioner. Employees must adhere to the following:

  • The new provider must be on the approved list of medical providers for workers' compensation cases.
  • Employees may only change their provider once every 180 days unless there are extenuating circumstances.
  • Notification of the change must be provided to the current provider and the workers' compensation insurance carrier.

How to Obtain the Workers Request To Change Attending Physician Or Authorized Nurse Practitioner Oregon

The Workers Request To Change Attending Physician Or Authorized Nurse Practitioner form can typically be obtained through the following methods:

  • Employer’s human resources department: Request a copy directly from your HR representative.
  • Workers' compensation insurance carrier: Contact your insurance provider for a copy of the form.
  • Online resources: Some state websites or legal aid organizations may provide downloadable versions of the form.

Quick guide on how to complete workers request to change attending physician or authorized nurse practitioner oregon

Forget about scanning and printing out forms. Use our detailed instructions to fill out and eSign your documents online.

Effortlessly Prepare [SKS] on Any Device

Managing documents online has become increasingly popular among businesses and individuals. It offers an ideal eco-friendly alternative to conventional printed and signed paperwork, allowing you to obtain the necessary form and securely store it online. airSlate SignNow equips you with all the tools needed to create, edit, and electronically sign your documents swiftly and without delays. Handle [SKS] on any device using airSlate SignNow's Android or iOS applications and enhance any document-related process today.

The easiest way to edit and eSign [SKS] seamlessly

  1. Locate [SKS] and select Get Form to begin.
  2. Utilize the tools we offer to complete your document.
  3. Emphasize pertinent sections of the documents or redact sensitive information with tools that airSlate SignNow provides specifically for that purpose.
  4. Generate your eSignature using the Sign feature, which takes just a few seconds and holds the same legal validity as a traditional handwritten signature.
  5. Review the information and click on the Done button to save your modifications.
  6. Choose how you wish to send your form, via email, SMS, or an invite link, or download it to your computer.

Eliminate concerns about lost or misplaced files, tedious form searches, or errors that necessitate printing new document copies. airSlate SignNow fulfills your document management requirements in a matter of clicks from any device you choose. Modify and eSign [SKS] while ensuring outstanding communication throughout the document preparation process with airSlate SignNow.

be ready to get more

Create this form in 5 minutes or less

Related searches to Workers Request To Change Attending Physician Or Authorized Nurse Practitioner Oregon

Workers request to change attending physician or authorized nurse practitioner oregon form
Workers request to change attending physician or authorized nurse practitioner oregon letter
Workers' compensation Oregon lookup
Oregon workers' compensation providers

Create this form in 5 minutes!

Use professional pre-built templates to fill in and sign documents online faster. Get access to thousands of forms.

People also ask

Here is a list of the most common customer questions. If you can’t find an answer to your question, please don’t hesitate to reach out to us.

Need help? Contact support

be ready to get more

Get this form now!

If you believe that this page should be taken down, please follow our DMCA take down process here.
airSlate SignNow