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Fill and Sign the Work Status Form Washington State Department of Labor

Fill and Sign the Work Status Form Washington State Department of Labor

How it works

Open the document and fill out all its fields.
Apply your legally-binding eSignature.
Save and invite other recipients to sign it.

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Enví e el formulario completo a : Department of Labor and Industries PO Box 44291 Olympia WA 98504 -4291 Cuestionario S obre la P érdida de A udición O cupacional Nombre Número de reclamo Fecha de la lesión 1. ¿Cuándo notó por primera vez la pérdida de audición ? 2. ¿Fue el inicio de la pérdida de audición : Repentino ? Gradual ? 3. ¿Qué clase de problema(s) de audición tiene ahora ? (Encierre en un círculo la letra de todos los conceptos aplicables). A. Zumbido en los oídos . B. Dificultad para escuchar en el teléfono. C. Dificultad para escuchar conversaciones entre usted y otra persona . D. Dificultad para entender la comunicación hablada en presencia de ruidos que lo rodean . E. Otro

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