Worker's and Health Care Provider's Report for Workers' Compensation Claims - Packet (Spanish) Forms


Form NameWorker's and Health Care Provider's Report for Workers' Compensation Claims - Packet (Spanish)
Form #440-827s
Form Revision7/22
CategoryForms » Medical/Health
Downloads
Form StateOregon
LanguageSpanish
State DescriptionCompleted by injured worker upon initial injury, when requesting acceptance of a new or omitted medical condition.
Claimwire Descriptionn/a
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