Form WC195 Notification by an Authorized Treating Provider - Colorado

Form WC195 Notification by an Authorized Treating Provider - Colorado

What Is Form WC195?

This is a legal form that was released by the Colorado Department of Labor and Employment - a government authority operating within Colorado. As of today, no separate filing guidelines for the form are provided by the issuing department.

FAQ

Q: What is a WC195 Notification by an Authorized Treating Provider?
A: A WC195 Notification by an Authorized Treating Provider is a form used in Colorado to notify the employer and insurance company about an injured worker's treatment.

Q: Who fills out the WC195 form?
A: The Authorized Treating Provider fills out the WC195 form.

Q: What information is included in the WC195 form?
A: The WC195 form includes information such as the injured worker's name, address, date of injury, and a description of the treatment being provided.

Q: How is the WC195 form submitted?
A: The WC195 form can be submitted electronically or by mail to the employer and insurance company.

Q: Why is the WC195 form important?
A: The WC195 form is important because it ensures that the employer and insurance company are notified about the injured worker's treatment, which can affect benefits and coverage.

ADVERTISEMENT

Form Details:

  • Released on January 1, 2018;
  • The latest edition provided by the Colorado Department of Labor and Employment;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;

Download a fillable version of Form WC195 by clicking the link below or browse more documents and templates provided by the Colorado Department of Labor and Employment.

Download Form WC195 Notification by an Authorized Treating Provider - Colorado

4.8 of 5 (9 votes)
  • Form WC195 Notification by an Authorized Treating Provider - Colorado, Page 1
ADVERTISEMENT