Physicians Initial Report Form | |
First L & I Visit Form | |
Form that is filled out by the doctor on a first visit for an L & I claim. | |
PIR | |
Handle: | Document-67720 |
Owner: | Hanson, Jean (User-867, 07736:EVERETT)DS |
Thursday, June 18, 2015 08:55:06 AM PDT | |
Tuesday, January 5, 2016 07:56:49 AM PST | |
Modified By: | |
Locked By: | |
| |
Allowed | |
Adobe Portable Document Format (.pdf) - application/pdf | |
PIR.pdf | |
No | |
4 | |
69401 | |
No | |
Appears In: | EMPLOYEE ON-THE-JOB INJURY FORMS |
Preferred Version: | Physicians Initial Report Form |