CC- Form 17 Physician Disclosure Statement - Oklahoma

CC- Form 17 Physician Disclosure Statement - Oklahoma

What Is CC- Form 17?

This is a legal form that was released by the Oklahoma Workers Compensation Commission - a government authority operating within Oklahoma. As of today, no separate filing guidelines for the form are provided by the issuing department.

FAQ

Q: What is CC- Form 17?
A: CC- Form 17 is a Physician Disclosure Statement in Oklahoma.

Q: What is the purpose of CC- Form 17?
A: CC- Form 17 is used to disclose any financial interest or relationship that a physician may have with a healthcare facility.

Q: Who needs to fill out CC- Form 17?
A: Physicians in Oklahoma who have financial interests or relationships with healthcare facilities need to fill out CC- Form 17.

Q: What should be included in CC- Form 17?
A: CC- Form 17 should include details of any financial interest or relationship with a healthcare facility, such as ownership, investment, compensation, or partnership.

Q: Is CC- Form 17 mandatory for all physicians?
A: Yes, all physicians in Oklahoma with financial interests or relationships with healthcare facilities are required to fill out CC- Form 17.

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Form Details:

  • Released on February 2, 2016;
  • The latest edition provided by the Oklahoma Workers Compensation Commission;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;

Download a fillable version of CC- Form 17 by clicking the link below or browse more documents and templates provided by the Oklahoma Workers Compensation Commission.

Download CC- Form 17 Physician Disclosure Statement - Oklahoma

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  • CC- Form 17 Physician Disclosure Statement - Oklahoma, Page 1
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