Fill and Sign United States Legal Forms

This form is used for requesting an exam in the state of Washington.

This document is a Form of Transfer of Care in Washington. It is used to transfer medical attention from one provider to another.

This form is used for transferring care in the state of Washington for individuals who speak Tigrinya.

This document is used for transferring care in Washington state. It is available in Urdu language.

This form is used for providing a statement regarding miscellaneous services in Washington, but it is in French.

This form is used for Japanese-speaking individuals residing in Washington state to request and provide statements for miscellaneous services.

This form is used for providing a statement relating to miscellaneous services in the state of Washington.

This form is used for pharmacies in Washington to provide a statement of services rendered. It is available in Chinese Simplified language.

This document is used to provide a statement for pharmacy services in Washington. It is written in French.

This form is used for stating pharmacy services in Washington State for Samoan speaking residents.

This form is used for requesting reimbursement for travel expenses and lost wages related to an Independent Medical Exam (IME) in Washington state.

This form is used for conducting a care assessment in Washington state. It helps evaluate the needs and eligibility for long-term care services.

This form is used for reporting the progress of Nurse Case Management (NCM) in Washington.

This form is used for providing a statement regarding training option 2 in Washington for Korean speakers.

This Form is used for assessing an individual's functional recovery in Washington state. It includes a questionnaire to gather information about the person's physical and mental well-being.

This form is used for conducting a behavioral health assessment in Washington State. It helps collect information about an individual's mental health and substance use to determine appropriate treatment options.

This Form is used for documentation related to a Pilot Complex Claim Case Conference in Washington.

This form is used for filing a pilot complex claim summary under the Washington State Department of Labor and Industries' PRP (Preferred Worker Program).

This form is used for musculoskeletal surgeons in Washington to apply for the Surgical Quality Care Program.

This form is used for out-of-country providers to register as payees in the state of Washington.

This type of document is a registration form for international providers who want to become beneficiaries of the State of Washington.

This form is used for making a third party election in Washington state specifically translated in Chuukese language.

This form is used for third party election in Washington state, specifically for individuals who speak Haitian Creole.

This document is used for submitting a Third Party Election Form in Washington state for individuals who are part of the Mien community.