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This form is used for submitting a medical report to apply for the CalPERS Disabled Dependent Benefit in California.

This form is used for reporting a disability in the state of California. It is typically completed by a physician to provide information about an individual's disability and its impact on their ability to work or perform daily activities. The report is often required for various disability benefits or accommodations.

This form is used for designating a beneficiary to receive a lump sum payment after retirement for nonmembers in California.

This form is used for designating a lump-sum beneficiary to receive retirement benefits after the employee's retirement in California.

This document is used for applicants who are applying to a public agency in California. It is a questionnaire that collects information about the applicant.

This form is used for reporting the separation for death of an employee and requesting payroll information in the state of California.

This document is used to request information about the cost of service credit for the Alternate Retirement Program in California.

This form is used for collecting information from applicants interested in attending schools in California. It helps schools gather details about the applicant's background, interests, and academic qualifications.

This form is used for service verification purposes in the state of California. It is used to validate an individual's employment or income in order to verify their eligibility for certain services or benefits.

This document is a rider that can be added to an existing letter of credit in the state of Colorado. It outlines specific terms and conditions that cannot be changed or revoked.

This form is used for obtaining informed consent from participants in Colorado before they can participate in a specific activity or study. It ensures that the participants have been fully informed about the risks, benefits, and potential consequences of their participation and gives them the opportunity to ask questions and make an informed decision.

This form is used by behavioral therapy providers in Colorado to attest to their qualifications and compliance with specific requirements.

This document is used for submitting paper claims in the state of Colorado. It is a request form that allows individuals or healthcare providers to submit claims for reimbursement or payment for medical services.

This document is used to request a waiver for overpayment in the state of Colorado. It is a form that individuals can submit if they believe they have been overpaid and are seeking to have the overpayment waived.

This document is used to keep track of your job search activities in Colorado. It helps you record important details such as the companies you have applied to, the dates of your applications, and any follow-up actions you have taken.

This form is used for requesting information from an insurer in the state of Colorado. It is used in cases where individuals or organizations need specific information from an insurance company.

This form is used for requesting utilization review in the state of Colorado. It is a request made by an individual or their representative to review the medical necessity and appropriateness of a recommended medical treatment or service.

This form is used for summarizing the examiner's division of IME (Independent Medical Examination) in Colorado.

This form is used for transmitting a worker's claim for compensation in Colorado. It serves as a communication document between the worker and the Colorado workers' compensation authority.

This form is used for providing notice and proposing the selection of an independent medical examiner in the state of Colorado.

This Form is used for requesting a disfigurement award in the state of Colorado. It may require submitting a photo as evidence.

This form is used for authorized treating providers in Colorado to request prior authorization for medical treatment.

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