Insurer's Request for Director Approval of an Additional Independent Medical Examination Forms
| Form Name | Insurer's Request for Director Approval of an Additional Independent Medical Examination |
| Form # | 440-2333 |
| Form Revision | 3/15 |
| Category | Forms » Medical/Health |
| Downloads | |
| Form State | Oregon |
| Language | English |
| State Description | Insurer's or self-insured employer's request for approval by the DCBS Director for an additional independent medical examination beyond the three allowed by administrative rules. |
| Claimwire Description | n/a |