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 Wcb Manitoba 2014

Wcb Manitoba 2014

Use a Wcb Manitoba 2014 template to make your document workflow more streamlined.

In the Optional Prior Approval program* You can obtain participation status from the WCB Website. B. Attending Doctor s Name Address Individual Provider s WCB Authorization No* - Fax No* Telephone No* C. DATE REQUEST SUBMITTED The undersigned requests optional prior approval under the WCB Medical Treatment Guidelines as indicated below Treatment/Procedure Requested In first box indicate injury and/or condition K Knee S Shoulder B Mid and Low Back N Neck C Carpal Tunnel P Non-Acute Pain* In...
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